/ft 


THE  LIBRARY 

OF 

THE  UNIVERSITY 

OF  CALIFORNIA 

LOS  ANGELES 


LITTLE  MASTERPIECES   OF   SCIENCE 


Little    Masterpieces 
of    Science 

Edited    by    George    lies 


HEALTH  AND  HEALING 

By 

Sir  James  Paget,  M.D.    Patrick  Geddes  and 
SirJ.  R.  Bennett,  M.D.   J.  Arthur  Thomson 
T.  M.  Prudden,  M.D.  B.W.Richardson, M.D. 
G.  M.  Sternberg, M.D.    Buel  P.  Colton 
Robson  Roose,  M.D.      J.  S.  Billings,  M.D. 


e^ 


NEW  YORK 

DOUBLEDAY,  PAGE   &  COMPANY 

1902 


Copyright,  1902,  by  Doubleday,  Page  &  Co. 

Copyright,  1894,  by  Harper  &  Brothers 

Copyright,  1901,  by  Popular  Science  Monthly 

Copyright,  1900,  by  D.  C.  Heath  &  Co. 

Copyright,  1901,  by  Evening  Post  Publishing  Co. 

Copyright,  1901,  by  G.  P.  Putnam's  Sons 


PREFACE 

When  we  remember  that  sound  health  is  the 
foundation  of  every  other  good,  of  all  work  fruit- 
ful and  enjoyed,  we  see  that  in  this  field  new 
knowledge  and  new  skill  have  won  their  most 
telling  victories.  Pain,  long  deemed  as  inevitable 
as  winter's  cold,  has  vanished  at  the  chemist's 
bidding:  the  study  of  minutest  life  is  resulting 
in  measures  which  promise  to  rid  the  world  of 
consumption  itself.  Dr.  Billings's  masterly 
review  of  medical  progress  during  the  nineteenth 
century,  following  upon  chapters  from  other 
medical  writers  of  the  first  rank,  strikes  Preven- 
tion as  its  dominant  note.  To-day  the  aim  of 
the  great  physicians  is  not  simply  to  restore 
health  when  lost,  but  the  maintenance  of  health 
while  still  unimpaired. 

Worthy  of  remark  is  the  co-operation  in  this 
good  task  which  the  physician  receives  at  the 
hands  of  the  inventor  and  the  man  of  business. 
To-day  the  railroad,  quick  and  cheap,  disperses 
crowded  cities  into  country  fields:  even  the 
poorest  of  the  poor  may  take  a  summer  outing 
on  mountain  slopes,  on  the  shores  of  lake  or  sea. 
As  easily  may  the  invalid  escape  the  rigors  of  a 
Northern  winter  as  he  journeys  to  the  Gulf  of 
Mexico.  For  those  who  stay  at  home  the  rail- 
road is  just  as  faithfully  at  work.  It  exchanges 
the  oranges  of  Florida  for  the  ice  of  Maine,  and 

V 


Preface 

brings  figs  and  peaches  from  California  to  New 
England  and  New  York.  These,  together  with 
the  cold  storage  warehouse  and  the  cannery, 
have  given  the  orchard  and  the  kitchen  garden 
all  seasons  for  their  own.  Nor  must  we  forget 
the  mills  that  offer  a  dozen  palatable  cereals  for 
the  breakfast  table,  most  of  the  drudgery  of 
preparation  shifted  from  the  kitchen  to  the 
factor}'.  Because  food  is  thus  various  and 
wholesome  as  never  before,  the  health  and 
strength  of  the  people  steadily  gains,  while 
medicine  falls  into  less  and  less  request ;  for  what 
is  medicine  three  times  in  ten  but  a  corrective 
for  a  poor  or  ill-balanced  diet  ? 

But  if  the  best  health  possible  is  to  be  enjoyed 
by  everybody,  the  co-operation  with  the  physi- 
cian must  include  everybody.  Already  a  con- 
siderable and  increasing  number  of  men  and 
women  understand  this.  If  they  have  any 
reason  to  suspect  organic  weakness  of  any  kind, 
they  have  recourse  to  the  physician's  advice,  to 
the  end  that  a  suitable  regimen,  or  a  less  exacting 
mode  of  livelihood,  may  forefend  all  threatened 
harm.  A  few  pages  of  this  volume  set  forth  the 
due  care  of  the  eyes:  the  work  from  which  those 
pages  is  taken  gives  hints  of  equal  value  regard- 
ing the  care  of  the  ears,  the  lungs  and  other 
bodily  organs,  so  much  more  easily  kept  sound 
than  restored  to  soundness  after  the  assail  of 
disease. 

George    Iles, 


CONTENTS 

PAGET,  SIR  JAMES,  M.D. 

Escape  from  Pain.     The  History  of  a 
Discovery 

About  1 800  Humphry  Davy  experimented  with  nitrous 
oxide  gas  and  suggested  its  use  in  surgery.  Horace 
Wells,  a  dentist  of  Hartford,  Conn.,  uses  the  gas  for 
the  painless  extraction  of  teeth.  Sulphuric  ether  also 
observed  to  produce  insensibility  to  pain.  Dr.  Crauford 
Long,  of  Jefferson,  Ga.,  uses  it  in  1842  for  the  excision 
of  a  tumour.  Wm.  T.  G.  Morton,  Boston,  employs 
ether  in  dentistry,  and  Dr.  Warren  in  surgery.  Dr. 
Simpson,  Edinburgh,  introduces  chloroform  to  pre- 
vent the  pains  of  child-birth.  Anaesthesia  not  only 
abolishes  pain,  it  broadens  the  scope  of  surgery  and 
makes  operations  safe  which  formerly  were  most 
perilous 3 

BENNETT,  SIR  J.  R.,  M.D. 

Jenner  and  Pasteur 

Jenner's  indebtedness  to  John  Hunter,  Jenner's 
early  observations  in  natural  history.  He  hears  a 
countrywoman  say,  "I  can't  take  smallpox  for  I  have 
had  cowpox."  This  sets  him  thinking.  He  finds 
that  of  various  forms  of  cowpox  but  one  gives  pro- 
tection against  smallpox.  In  i7q6  successfully  vac- 
cinates a  patient.  Holds  that  smallpox  and  cowpox 
are  modifications  of  the  same  disease  and  that  if  the 
system  be  impregnated  with  the  milder  disease,  im- 
munity from  the  severer  is  conferred.  Immense 
saving  of  life  by  vaccination. 
vii 


Contents 

Pasteur,  a  chemist  studies  fermentation,  which  is 
due  to  the  rapid  multiplication  of  organisms.  Similar 
organisms  he  detects  as  the  cause  of  the  silkworm 
disease  and  of  anthrax  in  cattle.  He  adopts  the 
method  of  Jenner,  prepares  an  attenuated  virus  and 
protects  cattle  from  anthrax 25 


GEDDES,    PATRICK,    AND   J.    ARTHUR 
THOMSON 

Pasteur  and  His  Work 

Distingtaishes  minute  facets,  not  before  observed,  in 
certain  chemical  compounds.  Proves  that  the  fermen- 
tation of  tartrate  of  lime  is  due  to  a  minnte  organism 
and  that  a  similar  agency  underlies  many  other  kinds 
of  fermentation.  Protects  wine  from  fermentation 
by  heating  it  for  a  minute  to  50°  C  Disproves  the 
theory  of  spontaneous  generation.  Discovers  an 
antitoxin   for  hydrophobia 51 


PRUDDEN,  T.  M.,  M.D. 

Tuberculosis  and  Its   Prevention 

In  Nature  an  extremely  important  part  is  played  by 
minute  organisms.  Some  of  them  take  up  their  abode 
in  the  human  body  and  there  set  up  diseases  of  which 
consumption  is  the  chief.  The  tubercle  bacillus  is 
the  sole  cause  of  consumption:  its  entrance  may  be 
prevented,  mainly  by  destroying  the  spittle  of  patients. 
Susceptibility  to  consumption  may  be  inherited:  the 
disease  itself  is  not.  Any  cause  which  lowers  vitality 
increases  susceptibility.  Dust  is  a  source  of  danger 
both  out-of-doors  and  in.  Dust  in  houses  should 
be  removed,  not  simply  stirred  up.     Encouragement 

for  sufferers  in  early  stages  of  disease 63 

viii 


Contents 

STERNBERG,  G.   M.,  M.D. 
Malaria  and  Mosquitoes 

Malaria,  long  believed  to  be  due  to  bad  air,  is  really- 
chargeable  to  a  mosqiiito  discovered  by  Dr.  Laveran, 
1880,  and  first  detected  in  America  by  Dr.  Sternberg, 
1886.  Healthy  individuals  inoculated  with  blood  con- 
taining the  parasite  develop  malarial  fever.  The 
mosquito  theory  of  infection  was  advanced  by  Dr. 
A.  F.  A.  King,  Washington,  1S83.  Dr.  Manson  and 
Dr.  Ross  confirmed  the  theory  by  observation  and 
experiment.  Five  individuals  exposed  to  the  July  air 
of  the  Roman  Campagna  escape  malaria  by  using 
screens  on  doors  and  windows  and  nets  over  their 
beds 89 

ROOSE,  ROBSON,  M.D. 

The  Art  of  Prolonging  Life 

What  is  the  natural  :;erm  of  life  ?  One  hundred  years 
the  extreme  limit.  Longevity  runs  in  families.  Cler- 
gymen are  long-lived.  Abstemiousness,  sound  diges- 
tion, capacity  for  sleep  usually  found  in  the  long-lived. 
Work  is  healthy,  especially  intellectual  work.  Reason- 
able hobbies  are  good.  Beyond  middle  life  exercise 
should  be  judicious.  Diet  should  be  digestible  and 
moderate.  Clothing  should  be  sensible  and  cleanliness 
habitual 107 

RICHARDSON,  B.  W.,  M.D. 
Natural  Life  and  Death 

Man  should  be  as  unconscious  of  death  as  of  birth. 
To  this  end  let  him  observe  the  rules  of  Health. 

Rules  of  Health 

The  health  of   the    unborn    should    be    ensured.     Many 
diseases  usual  in  children  may  be  avoided  by  isolation 
ix 


Contents 


and  disinfection.  An  equable  temperature  should  be 
maintained.  Regular  and  various  mental  labour  is  a 
benefit.  Physical  exercise  should  be  moderate.  The 
passions  should  obey  the  reason.  Alcohol  and  tobacco 
are  harmful.  Opium  and  other  narcotics  should  be 
shunned.  Not  too  much  meat.  Water  the  natural 
beverage.  Air  should  be  pure  and  not  damp.  Rest 
and  recreation  gainful.  Idleness  injurious.  Sleep 
should  be  adequate 137 

COLTOX,   BUEL  P. 

Care  of  the  Eyes 

Light  should  fall  from  behind  and  above:  it  should  be 
equal  for  both  eyes.  An  Argand  lamp  is  best.  Read- 
ing out-of-doors  is  harmful.  The  range  of  the  eye 
should  not  be  too  short.  Frequent  rests  do  good. 
Light  should  be  strong  enough.  The  easiest  reading 
should  be  saved  for  the  evening.  Reading  during 
convalesence  is  hurtful.  How  to  remove  foreign  sub- 
stances from  the  eye.     Cleanliness  essential.    .      •      .      155 

BILLINGS,  J,  S.,  M.D. 

Progress    of    Medicine    ix    the    Nine- 
teenth  Century 

More  medical  progress  in  the  nineteenth  century  than 
in  the  two  thousand  years  preceding.  The  surgeon 
does  more  and  better  work  than  ever:  he  can  locate 
a  tumour  of  the  brain.  Deformities  ameliorated. 
Perils  of  maternity  reduced.  Blindness  in  many 
cases  prevented.  Human  life  lengthening.  The 
prevention  of  disease  has  made  great  strides.  Pure 
water-supply,  proper  drainage  and  sewerage.  Diph- 
theria, typhoid  and  consumption  are  largely  prevent- 
able. Scientific  nursing  introduced.  Improvements 
in  hospital  construction  and  management.  .  .  .  i6x 
X 


HEALTH    AND    HEALING 


ESCAPE  FROM  PAIN:    THE  HISTORY   OF 
A  DISCOVERY 

Sir  James  Paget,  M.   D. 

[Sir  James  Paget  was  one  of  the  most  eminent  English  sur- 
geons of  the  last  century,  his  writings  on  surgical  themes  are 
of  the  first  authority.  The  essay,  the  chief  portions  of 
which  follow,  appeared  in  the  Nineteenth  Century  Magazine, 
December,  1879.  The  editor's  permission  to  reprint  is  thank- 
fully acknowledged.  The  essay  Js  contained  in  "Selected 
Essays  and  Addresses,"  by  Sir  James  Paget,  published  by 
Longmans,  Green  &  Co.,  1902.  The  same  firm  publishes 
"  Memoirs  and  Letters  of  Sir  James  Paget,  "edited  by  Stephen 
Paget,  one  of  his  sons.[] 

The  history  of  the  discovery  of  methods  for  the 
prevention  of  pain  in  surgical  operations  deserves 
to  be  considered  by  all  who  study  either  the 
means  by  which  knowledge  is  advanced  or  the 
lives  of  those  by  whom  beneficial  discoveries  are 
made.  And  this  history  may  best  be  traced  in 
the  events  which  led  to  and  followed  the  use  of 
nitrous  oxide  gas,  of  sulphuric  ether,  and  of 
chloroform  as  anaesthetics — that  is,  as  means  by 
which  complete  insensibility  may  be  safely  pro- 
duced and  so  long  maintained  that  a  surgical 
operation,  of  whatever  severity  and  however  pro- 
longed, may  be  absolutely  painless. 

In  1798,  Mr.  Humphry  Davy,  an  apprentice  to 
Mr.  Borlase,  a  surgeon  at  Bodmin,  had  so  dis- 
tinguished himself  by  zeal  and  power  in  the 
3 


Masterpieces  of   Science 

study  of  chemistr}'  and  natural  philosophy, 
that  he  was  in\-ited  by  Dr.  Beddoes,  of  Bristol, 
to  become  the  "superintendent  of  the  Pneu- 
matic Institution  which  had  been  established 
at  Clifton  for  the  purpose  of  tr\-ing  the  medicinal 
effects  of  different  gases."  He  obtained  release 
from  his  apprenticeship,  accepted  the  appoint- 
ment, and  devoted  himself  to  the  study  of  gases, 
not  only  in  their  medicinal  effects,  but  much 
more  in  all  their  chemical  and  physical  relations. 
After  two  years'  work  he  published  his  Re- 
searches, Chemical  and  Philosophical,  chiefly  con- 
cerning Nitrons  Oxide,  an  essay  pro\'ing  a  tnily 
mar\-elous  ingenuit}-,  patience,  and  courage 
in  experiements,  and  such  a  power  of  obser\-ing 
and  of  thinking  as  has  rarely  if  ever  been  sur- 
passed by  any  scientific  man  of  Da\'\-'s  age;  for 
he  was  then  only  twent3^-two. 

In  his  inhalations  of  the  nitrous  oxide  gas  he 
obser\-ed  all  the  phenomena  of  mental  excitement, 
of  exalted  imagination,  enthusiasm,  merriment, 
restlessness,  from  which  it  gained  its  popular 
name  of  "laughing  gas" ;  and  he  saw  people  made, 
at  least  for  some  short  time  and  in  some  measure, 
insensible  by  it.  So,  among  other  suggestions 
or  guesses  about  probable  medicinal  uses  of  in- 
halation of  gases,  he  wrote,  near  the  end  of  his 
essay:  "As  nitrous  oxide  in  its  extensive  opera- 
tion appears  capable  of  destroying  physical  pain, 
it  may  probably  be  used  -^^-ith  advantage  during 
surgical  operations  in  which  no  great  effusion  of 
blood  takes  place." 

4 


Escape    from    Pain 

It  seems  strange  that  no  one  caught  at  a  sug- 
gestion such  as  this.  True ,  the  evidence  on  which 
it  was  founded  was  very  shght;  it  was  with  a  rare 
scientific  power  that  Davy  had  thought  out  so 
far  beyond  his  facts ;  but  he  had  thought  clearly, 
and  as  clearly  told  his  belief.  Yet  no  one  ear- 
nestly regarded  it.  The  nitrous  oxide  might  have 
been  of  as  little  general  interest  a^  the  carbonic 
or  any  other,  had  it  not  been  for  the  strange  and 
various  excitements  produced  by  its  inhalation. 
These  made  it  a  favourite  subject  with  chemical 
lecturers,  and  year  after  year,  in  nearly  every 
chemical  theatre,  it  was  fun  to  inhale  it  after  the 
lecture  on  the  gaseous  compounds  of  nitrogen; 
and  among  those  who  inhaled  it  there  must  have 
been  many  who,  in  their  intoxication,  received 
sharp  and  heavy  blows,  but,  at  the  time,  felt 
no  pain.  And  this  went  on  for  more  than  forty 
years,  exciting  nothing  worthy  to  be  called 
thought  or  observation,  till,  in  December,  1844, 
Mr.  Colton,  a  popular  itinerant  lecturer  on 
chemistry,  delivered  a  lecture  on  "laughing  gas" 
in  Hartford,  Connecticut.  Among  his  auditors 
was  Mr.  Horace  Wells,  an  enterprising  dentist 
in  that  town,  a  man  of  some  power  in  mechanical 
invention.  After  the  lecture  came  the  usual 
amusement  of  inhaling  the  gas,  and  Wells,  in 
whom  long  wishing  had  bred  a  kind  of  belief  that 
something  might  be  found  to  make  tooth-draw- 
ing painless,  observed  that  one  of  the  men  ex- 
cited by  the  gas  was  not  conscious  of  hurting 
himself  when  he  fell  on  the  benches  and  bruised 
5 


Masterpieces   of  Science 

and  cut  his  knees.  Even  when  he  became  calm 
and  clear-headed  the  man  was  sure  that  he  did 
not  feel  pain  at  the  time  of  his  fall.  Wells  was  at 
once  con\4nced — more  easily  con\'inced  than 
a  man  of  more  scientific  mind  would  have  been 
— that,  during  similar  insensibility,  in  a  state  of 
intense  ner^'ous  excitement,  teeth  might  be 
drawn  without  pain,  and  he  determined  that 
himself  and  one  of  his  own  largest  teeth  should 
be  the  first  for  trial.  Next  morning  Colton 
gave  him  the  gas,  and  his  friend  Dr.  Riggs  ex- 
tracted his  tooth.  He  remained  unconscious 
for  a  few  moments,  and  then  exclaimed,  "A  new 
era  in  tooth-pulling  !  It  did  not  hurt  me  more 
than  the  prick  of  a  pin.  It  is  the  greatest  dis- 
covery ever  made." 

In  the  next  three 'weeks  Wells  extracted  teeth 
from  some  twelve  or  fifteen  persons  under  the 
influence  of  the  nitrous  oxide,  and  gave  pain  to 
only  two  or  three.  Dr.  Riggs,  also,  used  it  with 
the  same  success,  and  the  practice  was  well  known 
and  talked  of  in  Hartford. 

Encouraged  by  his  success  Wells  went  to  Bos- 
ton, \N-ishing  to  enlarge  the  reputation  of  his  dis- 
covery and  to  have  an  opportunity  of  giving  the 
gas  to  some  one  undergoing  a  surgical  operation. 
Dr.  J.  C.  Warren,  the  senior  Surgeon  of  the 
Massachusetts  General  Hospital,  to  whom  he 
applied  for  this  purpose,  asked  him  to  show 
first  its  effects  on  some  one  from  whom  he  would 
draw  a  tooth.  He  undertook  to  do  this  in  the 
theatre  of  the  medical  college  before  a  large  class 
6 


Escape    from    Pain 

of  students,  to  whom  he  had,  on  a  previous  day, 
explained  his  plan.  Unluckily,  the  bag  of  gas 
from  which  the  patient  was  inhaling  was  taken 
away  too  soon;  he  cried  out  when  his  tooth  was 
drawn;  the  students  hissed  and  hooted;  and 
the  discovery  was  denounced  as  an  imposture. 

Wells  left  Boston  disappointed  and  disheart- 
ened; he  fell  ill,  and  was  for  many  months  un- 
able to  practice  his  profession.  Soon  after- 
wards he  gave  up  dentistry,  and  neglected  the 
use  and  study  of  the  nitrous  oxide,  till  he  was 
recalled  to  it  by  a  discovery  even  more  impor- 
tant than  his  own. 

The  thread  of  the  history  of  nitrous  oxide  may 
be  broken  here. 

The  inhalation  of  sulphuric  ether  was  often, 
even  in  the  eighteenth  century,  used  for  the 
relief  of  spasmodic  asthma,  phthisis,  and  some 
other  diseases  of  the  chest.  Dr.  Beddoes  and 
others  thus  wrote  of  it:  but  its  utility  was  not 
great,  and  there  is  no  evidence  that  this  use  of  it 
had  any  influence  on  the  discovery  of  its  higher 
value,  unless  it  were,  ver}^  indirectly,  in  its  hav- 
ing led  to  its  being  found  useful  for  soothing 
the  irritation  produced  by  inhaling  chlorine. 
Much  more  was  due  to  its  being  used,  like  nitrous 
oxide,  for  the  fun  of  the  excitement  which  its 
diluted  vapor  would  produce  in  those  who  freely 
inhaled  it. 

The  beginning  of  its  use  for  this  purpose  is  not 
clear.  In  the  Journal  of  Science  and  the  Arts, 
published  in  1818  at  the  Royal  Institution, 
7 


Masterpieces   of   Science 

there  Is  a  short  anonymous  statement  among 
the  "Miscellanea,"  in  which  it  is  said,  "When  the 
vapor  of  ether  mixed  with  common  air  is  inhaled, 
it  produces  effects  very  similar  to  those  occa- 
sioned by  nitrous  oxide."  The  method  of  in- 
haling and  its  effects  are  described,  and  then 
"it  is  necessary  to  use  caution  in  making  experi- 
ments of  this  kind.  By  the  imprudent  inspiration 
of  ether  a  gentleman  was  thrown  into  a  very 
lethargic  state,  which  continued  with  occasional 
periods  of  intermission  for  more  than  thirty 
hours,  and  a  great  depression  of  spirits;  for 
many  da^^s  the  pulse  was  so  much  lowered  that 
considerable  fears  were  entertained  for  his  life." 

The  statement  of  these  facts  has  been  as- 
cribed to  Faraday,  under  whose  management 
the  joiunal  was  at  that  time  published.  But, 
whoever  wrote  or  whoever  may  have  read  the 
statement,  it  was,  for  all  useful  purposes,  as 
much  neglected  as  was  Davy's  suggestion  of 
the  utility  of  the  nitrous  oxide.  The  last  sen- 
tence, quoted  as  it  was  by  Pereira  and  others 
writing  on  the  uses  of  ether,  excited  much  more 
fear  of  death  than  hope  of  ease  from  ether- 
inhalation.  Such  effects  as  are  described  in  it 
are  of  exceeding  rarity;  their  danger  was  greatly 
over-estimated;  but  the  account  of  them  was 
enough  to  discourage  all  useful  research. 

But,  as  the  sulphuric  ether  would  "produce 

effects    very    similar    to    those    occasioned    by 

nitrous  oxide,'*  and  was  much  the  more  easy 

to  prociu*e,  It  came  to  be  often  inhaled,  for  amuse- 

8 


Escape    from    Pain 

ment,  by  chemists'  lads  and  by  pupils  in  the 
dispensaries  of  surgeons.  It  was  often  thus  used 
by  young  people  in  many  places  of  the  United 
States.  They  had  what  they  called  "ether- 
frolics,"  in  which  they  inhaled  ether  till  they 
became  merry,  or  in  some  other  way  absurdly 
excited  or,   sometimes,  completely  insensible. 

Among  those  who  had  joined  in  these  ether- 
frolics  was  Dr.  Wilhite  of  Anderson,  South 
Carolina.  In  one  of  them,  in  183 9, when  nearly 
all  of  the  party  had  been  inhaling  and  some  had 
been  laughing,  some  crying,  some  fighting — 
just  as  they  might  have  done  if  they  had  had 
the  nitrous  oxide  gas — Wilhite,  then  a  lad  of 
seventeen,  saw  a  negro  boy  at  the  door  and 
tried  to  persuade  him  to  inhale.  He  refused 
and  resisted  all  attempts  to  make  him  do  it, 
till  they  seized  him,  held  him  down,  and  kept 
a  handkerchief  wet  with  ether  close  over  his 
mouth.  Presently  his  struggles  ceased;  he  lay- 
insensible,  snoring,  past  all  arousing;  he  seemed 
to  be  dying.  And  thus  he  lay  for  an  hour,  till 
medical  help  came  and,  with  shaking,  slapping, 
and  cold  splashing,  he  was  awakened  and  suf- 
fered no   harm. 

The  fright  at  having,  it  was  supposed,  so 
nearly  killed  the  boy,  put  an  end  to  ether- 
frolics  in  that  neighbourhood;  but  in  1842  Wil- 
hite had  become  a  pupil  of  Dr.  Crauford  Long, 
practising  at  that  time  at  Jefferson  (Jackson 
Cotmty,  Georgia).  Here  he  and  Dr.  Long  and 
three  fellow-pupils  often  amused  themselves 
9 


Masterpieces    of   Science 

with  the  ether-inhalation,  and  Dr.  Long  ob- 
ser\^ed  that  when  he  became  furiously  excited, 
as  he  often  did,  he  was  unconscious  of  the  blows 
which  he,  by  chance,  received  as  he  rushed 
or  tumbled  about.  He  observ^ed  the  same  in 
his  pupils;  and  thinking  over  this,  and  em- 
boldened by  what  Mr.  Wilhite  told  him  of  the 
negro  boy  recovering  after  an  hour's  insensi- 
bility, he  determined  to  try  whether  the  ether- 
inhalation  would  make  any  one  insensible  of 
the  pain  of  an  operation.  So,  in  March,  1842, 
nearly  three  years  before  Wells's  observations 
with  the  nitrous  oxide,  he  induced  Mr.  Venable, 
who  had  been  very  fond  of  inhaling  ether,  to 
inhale  it  till  he  was  quite  insensible.  Then  he 
dissected  a  tumour  from  his  neck;  no  pain  was 
felt,  and  no  harm  followed.  Three  months  later, 
he  similarly  removed  another  tumour  from  him; 
and  again,  in  1842  and  1845,  he  operated  on 
three  other  patients,  and  none  felt  pain.  His 
operations  were  known  and  talked  of  in  his 
neighbourhood;  but  the  neighbourhood  w^as 
only  that  of  an  obscure  little  town;  and  he 
did  not  publish  any  of  his  observations.  The 
record  of  his  first  operation  was  only  entered 
in    his    ledger: 

"James  Venable,  1842.  Ether  and  excising 
tumour,    $2.00." 

He  waited  to  test  the  ether  more  thoroughly 

in  some  greater  operation  than  those  in  which 

he  had  yet  tried  it;  and  then  he  would  have 

published  his  account  of  it.    While  he  was  wait- 

10 


Escape    from    Pain 

ing,  others  began  to  stir  more  actively  in  busier 
places,  where  his  work  was  quite  unknown, 
not  even  heard  of. 

Among  those  with  whom,  in  his  unlucky 
visit  to  Boston,  Wells  talked  of  his  use  of  the 
nitrous  oxide,  and  of  the  great  discovery  which 
he  believed  that  he  had  made,  were  Dr.  Morton 
and  Dr.  Charles  Jackson,  men  widely  different 
in  character  and  pursuit,  but  inseparable  in 
the  next  chapter  of  the  history  of  anaesthetics. 

Morton  was  a  restless,  energetic  dentist,  a 
rough  man,  resolute  to  get  practice  and  make 
his  fortune.  Jackson  was  a  quiet,  scientific 
gentleman,  unpractical  and  unselfish,  in  good 
repute  as  a  chemist,  geologist,  and  mineral- 
ogist. At  the  time  of  Wells's  visit,  Morton,  who 
had  been  his  pupil  in  1842,  and  for  a  short  time 
in  1843  his  partner,  was  studying  medicine 
and  anatomy  at  the  Massachusetts  Medical 
College,  and  was  living  in  Jackson's  house. 
Neither  Morton  nor  Jackson  put  much  if  any 
faith  in  Wells's  story,  and  Morton  witnessed 
his  failure  in  the  medical  theatre.  Still,  Mor- 
ton had  it  in  his  head  that  tooth-drawing  might 
somehow  be  made  painless,  and  even  after 
Wells  had  retired  from  practice,  he  talked  with 
him  about  it,  and  made  some  experiments, 
but,  having  no  scientific  skill  or  knowledge, 
they  led  to  nothing.  Still,  he  would  not  rest, 
and  he  was  guided  to  success  by  Jackson,  whom 
Wells  advised  him  to  ask  to  make  some  nitrous 
oxide    gas    for   him. 

11 


Masterpieces   of   Science 

Jackson  had  long  known,  as  many  others 
had,  of  sulphuric  ether  being  inhaled  for  amuse- 
ment, and  of  its  producing  effects  like  those  of 
nitrous  oxide:  he  knew  also  of  its  employment 
as  a  remedy  for  the  irritation  caused  by  inhal- 
ing chlorine.  He  had  himself  used  it  for  this 
purpose,  and  once,  in  1842,  while  using  it,  he 
became  completely  insensible.  He  had  thus 
been  led  to  think  that  the  pure  ether  might 
be  used  for  the  prevention  of  pain  in  surgical 
operations;  he  spoke  of  it  with  some  scientific 
friends,  and  sometimes  ad\'ised  a  trial  of  it; 
but  he  did  not  urge  it  or  take  any  active  steps 
to  promote  even  the  trial.  One  evening,  Mor- 
ton, who  was  now  in  practice  as  a  dentist, 
called  on  him,  full  of  some  scheme  which  he 
did  not  divulge,  and  urgent  for  success  in  pain- 
less tooth-drawing.  Jackson  advised  him  to 
use  the  ether,  and  taught  him  how  to  use  it. 

On  that  same  evening,  the  30th  of  Septem- 
ber, 1846,  Morton  inhaled  the  ether,  put  him- 
self to  sleep,  and,  when  he  awoke,  found  that 
he  had  been  asleep  for  eight  minutes.  Instantly, 
as  he  tells,  he  looked  for  an  opportunity  of 
giving  it  to  a  patient;  and  one  just  then  coming 
in,  a  stout,  healthy  man,  he  induced  him  to 
inhale,  made  him  quite  insensible,  and  drew 
his  tooth  without  his  having  the  least  con- 
sciousness  of  what  was  done. 

But  the  great  step  had  yet  to  be  made — the 
step  which  Wells    would  have  tried  to    make 
if  his  test  experiment  had  not  failed.     Clearly, 
12 


Escape    from    Pain 

operations  as  swift  as  that  of  tooth-drawing 
might  be  rendered  painless,  but  could  it  be 
right  to  incur  the  risk  of  insensibility  long 
enough  and  deep  enough  for  a  large  surgical 
operation  ?  It  was  generally  believed  that  in 
such  insensibility  there  was  serious  danger 
to  life.  Was  it  really  so  ?  Jackson  advised  Mor- 
ton to  ask  Dr.  J.  C.  Warren  to  let  him  try,  and 
Warren  dared  to  let  him.  It  is  hard  now  to 
think  how  bold  the  enterprise  must  have  seemed 
to  those  who  were  capable  of  thinking  accu- 
rately   on    the    facts    then    known. 

The  first  trial  was  made  on  the  i6th  of  Oc- 
tober, 1846.  Morton  gave  the  ether  to  a  patient 
in  the  Massachusetts  General  Hospital,  and 
Dr.  Warren  removed  a  tumour  from  his 
neck.  The  result  was  not  complete  success; 
the  patient  hardly  felt  the  pain  of  cutting, 
but  he  was  aware  that  the  operation  was  being 
performed.  On  the  next  day,  in  a  severer 
operation  by  Dr.  Hayward,  the  success  was  per- 
fect; the  patient  felt  nothing,  and  in  long  in- 
sensibility there  was  no  appearance  of  danger 
to    life. 

The  discovery  might  already  be  deemed 
complete,  for  the  trials  of  the  next  following 
days  had  the  same  success,  and  thence  on- 
wards the  use  of  the  ether  extended  over  con- 
stantly widening  fields.  A  coarse  but  feeble 
opposition  was  raised  by  some  American  den- 
tists; a  few  siu-geons  were  over-cautious  in 
their  warnings  against  suspected  dangers;  a 
13 


Masterpieces   of   Science 

few  maintained  that  pain  was  ven^  usefiil, 
necessary^  perhaps  to  sound  healing;  some  were 
hindered  by  their  dislike  of  the  patent  which 
Morton  and  Jackson  took  out;  but  as  fast  as 
the  news  could  be  carried  from  one  continent 
to  another,  and  from  town  to  town,  so  fast  did 
the  use  of  ether  spread.  It  might  almost  be 
said  that  in  even,'  place,  at  least  in  Europe, 
where  the  discover}-  was  promoted  more  quickly 
than  in  America,  the  month  might  be  named 
before  which  all  operative  surgery-  was  agonizing, 
and    after    which    it    was    painless. 

But  there  were  other  great  pains  3^et  to  be 
prevented,  the  pains  of  childbirth.  For  escape 
from  these  the  honour  and  deep  gratitute  are 
due  to  Sir  James  Simpson.  No  energ}',  or  knowl- 
edge, or  power  of  language  less  than  his  could 
have  overcome  the  fears  that  the  insensibility, 
which  was  proved  to  be  harmless  in  surgical 
operations  and  their  consequences,  should  be 
often  fatal  or  ver>'  mischievous  in  parturition. 
And  to  these  fears  were  added  a  crowd  of  pious 
protests  (raised,  for  the  most  part,  by  men) 
against  so  gross  an  interference  as  this  seemed 
with  the  ordained  course  of  human  nature.  Simp- 
son, with  equal  force  of  words  and  work,  beat 
all  do^-n;  and  by  his  adoption  of  chloroform 
as  a  substitute  for  ether  promoted  the  whole  use  of 
anaesthetics. 

Ether  and  chloroform   seemed  to   supply   all 
that   could  be  vv-ished  from  anaesthetics.      The 
range  of  their  utility  extended;  the  only  ques- 
14 


Escape   from  Pain 

tion  was  as  to  their  respective  advantages,  a 
question  still  unsettled.  Their  potency  was 
found  absolute,  their  safety  very  nearly  com- 
plete, and,  after  the  death  of  Wells  in  1848, 
nitrous  oxide  was  soon  neglected  and  almost 
forgotten.  Thus  it  remained  till  1862,  nearly 
seventeen  years,  when  Mr.  Colton,  who  still 
continued  lecturing  and  giving  the  gas  "for 
fun,"  was  at  New  Haven,  Connecticut.  He 
had  often  told  what  Wells  had  done  with  nitrous 
oxide  at  Hartford,  and  he  wanted  other  dentists 
to  use  it,  but  none  seemed  to  care  for  it  till,  at 
New  Britain,  Dr.  Dunham  asked  him  to  give 
it  to  a  patient  to  whom  it  was  thought  the 
ether  might  be  dangerous.  The  result  was  ex- 
cellent, and  in  1863  Dr.  Smith  of  New  Haven 
substituted  the  nitrous  oxide  for  ether  in  his 
practice  and  used  it  very  frequently.  In  the 
nine  months  following  his  first  use  of  it,  he 
extracted  without  pain  nearly  4,000  teeth. 
Colton,  in  the  following  year,  associated  him- 
self with  a  dentist  in  New  York  and  established 
the  Colton  Dental  Association,  where  the  gas 
was  given  to  many  thousands  more.  Still,  its 
use  was  very  slowly  admitted.  Some  called  it 
dangerous,  others  were  content  with  chloro- 
form and  ether,  others  said  that  the  short  pangs 
of  tooth-drawing  had  better  be  endured.  But  in 
1867  Mr.  Colton  came  to  Paris  and  Dr.  Evans 
at  once  promoted  his  plan.  In  1868  he  came 
to  London  and,  after  careful  study  of  it  at  the 
Dental  Hospital,  the  nitrous  oxide  was  speedily 
15 


Masterpieces   of   Science 

adopted,  both  by  dentists  and  by  the  admin- 
istrators of  anaesthetics.  By  this  time  it  has 
saved  hundreds  of  thousands  of  people  from 
the  sharp  pains  of  all  kinds  of  operations  on 
the  teeth  and  of  a  great  number  of  the  surgical 
operations   that  can   be   quickly   done. 

Such  is  the  history  of  the  discovery  of  the 
use  of  anaesthetics.  Probably,  none  has  ever 
added  so  largely  to  that  part  of  happiness  which 
consists  in  the  escape  from  pain.  Past  all  count- 
ing is  the  sum.  of  happiness  enjoyed  by  the 
millions  who,  in  the  last  three-and- thirty  years, 
have  escaped  the  pains  that  were  ine\'itable 
in  surgical  operations;  pains  made  more  ter- 
rible by  apprehension,  more  keen  by  close  at- 
tention; sometimes  awful  in  a  swift  agony, 
sometimes  prolonged  beyond  even  the  most 
patient  endurance,  and  then  renewed  in  memory 
and  terrible  in  dreams.  These  will  never  be 
felt  again.  But  the  value  of  the  discovery  is 
not  limited  by  the  abolition  of  these  pains  or 
the  pains  of  childbirth.  It  would  need  a  long 
essay  to  tell  how  it  has  enlarged  the  field  of 
useful  surgery,  making  many  things  easy  that 
were  difficult,  many  safe  that  were  too  peril- 
ous, many  practicable  that  were  nearly  im- 
possible. And,  yet  more  variously,  the  dis- 
covery has  brought  happiness  in  the  relief  of 
some  of  the  intensest  pains  of  sickness,  in  quiet- 
ing convulsion,  in  helping  to  the  discrimina- 
tion of  obscure  diseases.  The  tale  of  its  utility 
would  not  end  here;  another  essay  might  tell 
16 


Escape  from  Pain 

its  multiform  uses  in  the  study  of  physiology, 
reaching  even  to  that  of  the  elemental  processes 
in  plants,  for  these,  as  Claude  Bernard  has 
shown,  may  be  completely  for  a  time  suspended 
in  the  sleep  produced  by  chloroform  or  ether. 

And  now,  what  of  the  discoverers?*  What 
did  time  bring  to  those  who  brought  so  great 
happiness    to    mankind  ? 

Probably  most  people  would  agree  that 
Long,  Wdls,  Morton  and  Jackson  deserved 
rewards,     which     none     of    the     four   received. 

*Those  only  are  here  reckoned  as  discoverers  from  whose 
work  may  be  traced  not  merely  what  might  have  been  the  be- 
ginning of  the  discovery,  but  the  continuous  history  of  events 
consequent  upon  the  evidence  of  its  truth.  Long,  it  is  true, 
might  under  this  rule  be  excluded;  yet  his  work  cannot 
fairly  be  separated  from  the  history.  Of  course,  in  this,  as  in 
every  similar  case,  there  were  some  who  maintained  that 
there  was  nothing  new  in  it.  Before  1842  there  were  many 
instances  in  which  persons  underwent  operations  during  in- 
sensibility. There  may  be  very  reasonable  doubts  about 
what  is  told  of  the  ancient  uses  of  Indian  hemp,  and  man- 
dragora;  but  most  of  those  who  saw  much  surgery  before  1 846- 
must  have  seen  operations  done  on  patients  during  insen- 
sibility produced  by  narcotics,  dead-drunkenness,  mesmer- 
ism, large  losses  of  blood  or  other  uncertain  and  often  im- 
practicable methods.  Besides,  there  were  many  guesses  and 
suggestions  for  making  operations  painless.  But  they  were 
all  fruitless;  and  they  fail  at  that  which  may  be  a  fair  test 
for  most  of  the  claims  of  discoverers — the  test  of  consequent 
and  continuous  history.  When  honour  is  claimed  for  the 
authors  of  such  fruitless  works  as  these,  it  may  fairly  be  said 
that  blame  rather  than  praise  is  due  to  them.  Having  seen 
so  far  as  they  profess,  they  should  not  have  rested  till  they 
could  see  much  further. 

17 


Masterpieces   of   Science 

But  that  which  the  controversy  and  the  patent 
and  the  employment  of  legal  advisers  made 
it  necessary''  to  determine  was,  whether  more 
than  one  deser\'ed  reward,  and,  if  more  than 
one,  the  proportion  to  be  assigned  to  each. 
Here  v/as  the  diffictdty.  The  French  Academy 
of  Sciences  in  1850  granted  equal  shares  in 
the  Monthyon  Prize  to  Jackson  and  to  Morton; 
but  Long  was  unkno'\^'Ti  to  them,  and,  at  the 
time  of  the  award,  the  value  of  nitrous  oxide 
was  so  hidden  by  the  greater  value  of  ether 
that  Wells's  claim  was  set  aside.  A  memorial 
column  was  erected  at  Boston,  soon  after  ]\Ior- 
ton's  death  in  186S,  and  here  the  difficulty  was 
shirked  by  dedicating  the  column  to  the  dis- 
cover}^ of  ether,  and  not  naming  the  discoverers. 
The  difficulty  could  not  be  thus  settled;  and, 
in  all  probability,  our  supposed  coiuicil  of  four 
or  five  would  not  solve  it.  One  would  prefer 
the  claims  of  absolute  priority;  another  those 
of  suggestive  science;  another  the  courage  of 
bold  adventure;  sentiment  and  sympathy  would 
variously  affect  their  judgments.  And  if  we 
suppose  that  they,  like  the  American  Congress, 
had  to  discuss  their  differences  within  sound 
of  such  controversies  as  followed  Morton's  first 
use  of  ether,  or  during  a  war  of  pamphlets,  or 
under  burdens  of  parliamentary  papers,  we 
should  expect  that  their  clearest  decision  would 
be  that  a  just  decision  could  not  be  given,  and 
that  gratitude  must  die  if  it  had  to  wait  till 
distributive  justice  could  be  satisfied.  The 
18 


Escape  from  Pain 

gloomy  fate  of  the  American  discoverers  makes 
one  wish  that  gratitude  could  have  been  let 
flow  of  its  own  impulse;  it  would  have  done 
less  wrong  than  the  desire  for  justice  did.  A 
lesson  of  the  whole  story  is  that  gratitude  and 
justice  are  often  incompatible;  and  that  when 
they  conflict,  then,  usually,  "the  more  right 
the    more    hurt." 

Another  lesson,  which  has  been  taught  in  the 
history  of  many  other  discoveries,  is  clear  in 
this — the  lesson  that  great  truths  may  be  very 
near  us  and  yet  be  not  discerned.  Of  course,  the 
way  to  the  discover}^  of  anaesthetics  was  much 
more  difficult  than  it  now  seems.  It  was  very 
difficult  to  produce  complete  insensibility  with 
nitrous  oxide  till  it  could  be  given  undiluted 
and  unmixed;  this  required  much  better  ap- 
paratus than  Davy  or  Wells  had;  and  it  was 
hardly  possible  to  make  such  apparatus  till 
india-rubber  manufactures  were  improved.  It 
was  very  difficult  to  believe  that  profound 
and  long  insensibility  could  be  safe,  or  that 
the  appearances  of  impending  death  were  alto- 
gether fallacious.  Bold  as  Davy  was,  bold  even 
to  recklessness  in  his  experiments  on  himself, 
he  would  not  have  ventured  to  produce  de- 
liberately in  any  one  a  state  so  like  a  final  suffo- 
cation as  we  now  look  at  unmoved.  It  was  a 
boldness  not  of  knowledge  that  first  made  light 
of  such  signs  of  dying,  and  found  that  what 
looked  like  a  sleep  of  death  was  as  safe  as  the 
beginning  of  a  night's  rest.  Still,  with  all  fair 
19 


Masterpieces   of   Science 

allowance  for  these  and  other  difficulties,  "we  can- 
not but  see  and  wonder  that  for  more  than  forty 
years  of  the  nineteenth  century  a  great  truth 
lay  unobserv-ed,  though  it  was  covered  with 
only  so  thin  a  veil  that  a  careful  physiological 
research  must  have  discovered  it.  The  dis- 
covery ought  to  have  been  made  by  following 
the  suggestion  of  Daw.  The  book  in  which 
he  wrote  that  "  nitrous  oxide — cabable  of  de- 
stroj'ing  physical  pain — may  probably  be  used 
with  advantage  during  surgical  operations," 
was  widely  read,  and  it  would  be  hard  to  name  a 
man  of  science  more  widely  known  and  talked 
of  than  he  was.  Within  two  years  of  the  pub- 
lication of  his  Researches  he  was  appointed 
to  a  professorship  in  the  Royal  Institution; 
and  in  the  next  3-ear  he  was  a  favourite  in  the 
fashionable  as  well  as  in  the  scientific  world; 
and  all  his  hfe  through  he  was  intimately  asso- 
ciated with  those  among  whom  all  the  various 
motives  for  desiring  to  find  some  means  "cap- 
able of  destroying  physical  pain"  would  be 
most  strongly  felt.  Curiosity,  the  love  of  truth, 
the  love  of  marvels,  the  desire  of  ease,  self- 
interest,  benevolence, — all  were  alert  in  the 
minds  of  men  and  women  who  knew  and  trusted 
whatever  Daw  said  or  wrote,  but  not  one  mind 
was  earnestly  directed  to  the  rare  promise  which 
his  words  contained.  His  own  mind  was  turned 
with  its  full  force  to  other  studies;  the  interest 
in  surger>^  which  he  may  have  felt  during  his 
apprenticeship  at  Bodmin  was  lost  in  his  de- 
20 


Escape  from  Pain 

votion  to  poetry,  philosophy,  and  natural 
science,  and  there  is  no  evidence  that  he  urged 
others  to  undertake  the  study  which  he  left. 
Even  his  biographers,  his  brother,  Dr.  John 
Davy,  and  his  intimate  friend,  Dr.  Paris,  both 
of  whom  were  very  capable  physicians  and 
men  of  active  intellect,  say  nothing  of  his 
suggestion  of  the  use  of  nitrous  oxide.  It  was 
overlooked  and  utterly  forgotten  till  the  proph- 
ecy was  fulfilled  by  those  who  had  never 
heard  of  it.  The  same  may  be  said  of  what 
Faraday,  if  it  were  he,  wrote  of  the  influence 
of  sulphuric  ether.  All  was  soon  forgotten, 
and  the  clue  to  the  discovery,  which  would 
have  been  far  easier  with  ether  than  with  nitrous 
oxide,  for  it  needed  no  apparatus  and  even 
required  mixture  with  air,  was  again  lost.  One 
could  have  wished  that  the  honour  of  bringing 
so  great  a  boon  to  men,  and  so  great  a  help 
in  the  pursuit  of  knowledge,  had  been  won  by 
some  of  those  who  were  giving  themselves  with 
careful  cultivation  to  the  search  for  truth  as 
for  its  own  sake.  But  it  was  not  so:  science  was 
utterly  at  fault;  and  it  was  shown  that  in  the 
search  for  truth  there  are  contingencies  in 
which  men  of  ready  belief  and  rough  enter- 
prise, seeking  for  mere  utility  even  with  selfish 
purposes,  can  achieve  more  than  those  who 
restrain  themselves  within  the  range  of  what 
seems    reasonable. 

Such  instances  of  delay  in  the   discovery  of 
truth  are  always  wondered  at,  but  they  are  not 
21 


Masterpieces   of   Science 

uncommon.  Long  before  Jenner  demonstrated 
the  utility  of  vaccination  it  was  knowTi  in  Glou- 
cestershire that  they  who  had  had  cow-pox 
could  not  catch  the  small-pox.  For  some  years 
before  the  invention  of  electric  telegraphy, 
Professor  Gumming  of  Cambridge,  when  de- 
scribing to  his  class  the  then  recent  disco ven,- 
by  Oersted  of  the  power  of  an  electric  current 
to  deflect  a  magnet,  used  to  say,  "Here,  then, 
are  the  elements  which  would  excellently  ser\'e 
for  a  system  of  telegraphy."  Yet  none  of  his 
hearers,  active  and  cultivated  as  they  were, 
were  moved  from  the  routine  of  study.  Laennec 
quotes  a  sentence  from  Hippocrates  which,  if 
it  had  been  worthily  studied,  might  have  led 
to  the  full  discover}-  of  auscultation  [trained 
listening  to  soimds].  Thus  it  often  has  been; 
and  few  prophecies  can  be  safer  than  that  our 
successors  v^-ill  wonder  at  us  as  we  do  at  those 
before  us;  will  wonder  that  we  did  not  discern  the 
great  truths  which  they  will  sa}^  were  all  around 
us,  within  reach  of  any  clear,  earnest  mind. 

They  will  wonder,  too,  as  we  may,  when  we 
study  the  history-  of  the  discover}^  of  anaes- 
thetics, at  the  quietude  with  which  habitual 
miseries  are  borne;  at  the  ver}^  faint  impulse 
to  action  which  is  given  by  even  great  neces- 
sities when  they  are  habitual.  Thinking  of 
the  pain  of  surgical  operations,  one  would  think 
that  men  would  have  rushed  after  the  barest 
chance  of  putting  an  end  to  it  as  they  would 
have  rushed  to  escape  from  starving.  But  it 
22 


Escape  from  Pain 

was  not  so;  the  misery  wafe  so  frequent,  so 
nearly  customary,  deemed  so  inevitable,  that, 
though  it  excited  horror  when  it  was  talked 
of,  it  did  not  excite  to  strenuous  action,  Reme- 
*dies  were  wished  for  and  sometimes  tried,  but 
all  was  done  vaguely  and  faintly;  there  was 
neither  hope  enough  to  excite  intense  desire, 
nor  desire  enough  to  encourage  hope;  the  misery 
was  "put  up  with"  just  as  we  now  put  up 
with  typhoid  fever  and  sea-sickness,  with  local 
floods  and  droughts,  with  the  waste  of  health 
and  wealth  in  the  pollution  of  rivers,  with 
hideous  noises  and  foul  smells,  and  many  other 
miseries.  Our  successors,  when  they  have 
remedied  or  prevented  them,  will  look  back 
on  them  with  horror,  and  on  us  with  wonder 
and  contempt  for  what  they  will  call  our  idle- 
ness or  blindness  or  indifference  to  suffering. 


23 


JENNER  AND  PASTEUR 
Sir  J.  RiSDON   Bennett,  M.  D. 

[Sir  J.  Risdon  Bennett  was  a  leading  physician  of  London 
for  many  years,  holding  the  highest  offices  as  an  educator 
and  administrator.  The  article  from  which  the  following 
extracts  have  been  taken  appeared  in  the  Leisure  Hour,  1882,] 

No  department  of  medical  science  has  made 
greater  advances  in  modem  times  than  that 
which  is  termed  "Preventive  Medicine."  Nor 
is  there  any  in  which  the  public  at  large  is  more 
deeply  interested,  and  the  knowledge  of  which 
it  is  of  more  importance  should  be  diffused  as 
widely  as  possible.  The  devoted  and  zealous 
service  rendered  by  the  medical  profession 
in  all  questions  relating  to  the  maintenance 
of  health  and  the  prevention  of  disease  is  a 
sufficient  answer,  if  any  be  needed,  to  the  igno- 
rant and  prejudiced  statements  that  are  some- 
times made,  that  in  support  of  various  scien- 
tific theories  and  proceedings  medical  men  are 
actuated  by  interested  and  selfish  motives. 
No  name  stands,  or  will  ever  stand,  out  more 
brilliant  among  the  benefactors  of  mankind 
than  that  of  Edward  Jenner,  by  whose  genius 
and  labours  untold  multitudes  of  human  lives 
have  been  saved,  and  an  incalculable  amount 
of  human  suffering  and  misery  prevented.  At 
the  present  time  various  circumstances,  both 
social  and  scientific,  have  combined  to  recall 
25 


Masterpieces  of  Science 

attention  to  this  illustrious  man  and  his  remark- 
able scientific  and  beneficial  labours.  It  is  not, 
however,  our  intention  on  the  present  occasion 
to  give  either  a  complete  sketch  of  his  life,  or 
a  detailed  account  of  his  work.  But  in  order  to 
show  the  connection  between  his  discoveries 
and  more  recent  advances  in  the  same  field 
of  scientific  investigation,  it  will  be  necessary 
to  give  a  brief  resume  of  Tenner's  life-work, 
and  the  benefits  which  he  conferred  on  the 
human   race   throughout   the   world. 

He  was  bom  on  the  17  th  May,  1749.  at 
Berkeley,  in  Gloucestershire,  of  which  place 
his  father  was  the  \-icar.  On  leaving  Dr.  Wash- 
boiirn's  school,  at  Cirencester,  he  was  appren- 
ticed to  Mr.  Ludlow,  a  gentleman  in  practice 
as  a  surgeon  at  Sudbur\',  near  Bristol.  On  the 
completion  of  his  apprenticeship  he  came  to 
London,  and  had  the  good  fortune  to  be  placed 
under  the  care  of  the  celebrated  John  Hunter. 
with  whom  he  resided  for  two  years.  The  ob- 
sen-ing  powers  and  taste  for  natural  histon.' 
which  Jenner  had  early  shown,  as  a  bo}',  were 
quickened  and  fostered  by  the  daih'  example 
and  friendship  of  the  illustrious  man  who,  as 
surgeon  and  lecturer  at  St.  George's  Hospital, 
was  carrying  on  those  laborious  scientific  in- 
vestigations, and  building  up  that  mar\'elous 
monument  of  his  genius,  which  have  rendered 
his  name  and  fame  immortal.  So  much  skill 
and  knowledge  had  been  shown  by  Jenner  in 
arranging  the  natural  history*  collection  of  Sir 
26 


Jenner   and   Pasteur 

J.  Banks,  to  whom  he  had  been  recommended 
by  Hunter,  that  he  was  offered  the  appoint- 
ment of  naturalist  to  Captain  Cook's  second 
expedition.  He,  however,  decHned  this  and 
other  flattering  proposals,  in  order  to  return  to 
the  rural  scenes  of  his  boyhood,  and  be  near 
an  elder  brother  who  had  been  the  guide  of  his 
orphanhood.  He  rapidly  acquired  an  extensive 
business  as  a  general  practitioner,  while  his 
polished  manners,  wide  culture,  and  kind  and 
genial  social  qualifications,  secured  him  welcome 
admission  to  the  first  society  of  his  neighbour- 
hood. His  conscientious  devotion  to  his  pro- 
fessional duties  did  not,  however,  quell  his 
enthusiastic  love  of  natural  history,  or  pre- 
clude him  from  gaining  a  distinguished  repu- 
tation as  a  naturalist.  A  remarkable  paper 
on  the  cuckoo,  read  before  the  Royal  Society 
and  printed  in  the  Transactions,  gained  him  the 
fellowship  of  that  illustrious  body.  Jenner's 
paper  established  what  has  been  properly  termed 
the  "parasitic"  character  of  the  cuckoo,  i.  e., 
it  deposits  its  eggs  in  the  nests  of  other  birds,  by 
whose  warmth  they  are  hatched,  and  by  whom 
the  young  are  fed.  His  observations  have  re- 
ceived general  confirmation  by  subsequent 
observers,  more  especially  the  remarkable  facts 
that  the  parent  ^cuckoo  selects  the  nests  of 
those  birds  whose  eggs  require  the  same  period 
of  time  for  their  incubation  as  its  own  (which 
are  much  larger),  and  the  food  of  whose  young 
is  the  same,  viz.,  insects,  which  the  young 
27 


^Masterpieces   of   Science 

cuckoo     ultimately     monopolizes     b}'     ousting 
the  young  of  the  rightful  owner  of  the  nest. 

By  this  and  similar  studies  was  Jenner  pre- 
paring his  acute  powers  of  investigation  for 
the  great  purpose  of  his  life.  For  this  he  se- 
cured more  time  and  more  extended  oppor- 
tunities for  inquirs'  by  abandoning  general 
practice,  and  confining  himself  to  medicine 
proper,  having  obtained,  in  1792,  the  degree 
of  M.  D.  from  the  University  of  St.  Andrews. 
In  conjunction  T^-ith  the  "dear  man,"  as  he 
used  to  call  his  great  master,  John  Hunter, 
he  carried  on  his  experiments  illustrative  of 
the  structtu-e  and  functions  of  animals.  With 
great  industr}^  and  ingenmty  he  explained  some 
of  the  unaccotmtable  problems  in  ornithology^; 
he  ascertained  the  laws  which  regulate  the 
migration  of  birds;  made  considerable  ad- 
vances in  geology  and  in  our  knowledge  of  or- 
ganic remains;  he  amended  various  pharma- 
ceutical processes;  he  was  an  acute  anatomist 
and  pathologist,  and  investigated  and  ex- 
plained one  of  the  most  painful  affections  of 
the  heart,  and  many  of  the  diseases  to  which 
animals  are  liable.  By  such  labours  he  estab- 
blished  a  just  claim  to  distinction  as  a  medical 
philosopher,  apart  from  his  claims  to  the  grati- 
tude and  admiration  of  mankind  by  his  self- 
den^'ing  and  devoted  labours  in  connection 
"VNT-th  his  great  discover}-;  but  like  other  great 
men  absorbed  in  the  establishing  of  important 
truths,  he  was  regardless  of  personal  objects, 
28 


Jenner  and   Pasteur 

and  nev^'er  ostentatiously  promulgated  his  claims 
to  public  distinction. 

It  was  while  still  a  youth,  living  with  his 
master  at  Sudbury,  that  his  mind  first  became 
deeply  impressed  on  the  subject  of  the  cow- 
pox.  A  young  country  woman  came  to  seek 
advice,  when  the  subject  of  small-pox  was 
incidentally  mentioned  in  her  presence,  and 
she  immediately  observed,  "I  cannot  take 
that  disease,  for  I  have  had  cow-pox."  This 
was  a  popular  notion  prevalent  in  the  district, 
and  not  unknown  to  Jenner,  but  from  this  time 
he  never  ceased  to  think  on  the  subject.  On 
coming  to  London  he  mentioned  it  to  several 
persons,  and  among  others  to  Hunter;  but  all 
thought  his  notion  of  getting  rid  of  small-pox 
Utopian,  and  gave  him  little  or  no  encourage- 
ment. Hunter,  however,  who  never  liked  to 
daunt  the  enthusiasm  of  inquirers,  said,  in  his 
characteristic  way:  "Don't  think,  but  try;  be 
patient,  be  accurate."  About  the  3^ear  1775, 
some  time  after  his  return  to  the  country,  he  first 
had  the  opportunity  of  examining  into  the  truth 
of  the  common  traditions  regarding  cow-pox, 
but  it  was  not  until  1780,  after  much  study 
and  careful  inquiry,  that  he  was  able  to  un- 
ravel the  various  obscurities  and  contradic- 
tions with  which  the  subject  was  involved,  and 
in  that  year  he  first  disclosed  his  hopes  and  his 
fears  to  his  friend,  Edward  Gardner.  His  mind 
seems  to  have  caught  a  glimpse  of  the  repu- 
tation avv^aiting  him,  and  he  felt  that,  in  God's 
29 


Masterpieces   of   Science 

good  providence,  it  "might  be  his  lot  to  stand 
between  the  Hving  and  the  dead,  and  that  through 
him  a  great  plague  might  be  stayed." 

It  would  be  impossible  in  the  brief  space 
at  our  disposal  to  recount  the  various  diffi- 
culties and  sources  of  error  that  Jenner  en- 
countered. It  may,  however,  be  mentioned 
that  he  ascertained  that  there  was  more  than 
one  form  of  local  disease  with  which  cows  are 
afflicted,  and  which  may  give  rise  to  sores  on 
the  hands  of  milkmaids,  but  that  one  only  of 
these  was  the  true  cow-pox,  gi\'ing  origin  to 
constitutional  as  well  as  local  disease,  and  which 
proves  protective  against  small-pox.  He  also 
found  reason  to  believe  that  it  was  only  in  a 
particular  stage  of  its  development  that  the 
true  cow-pox  vesicle  was  capable  of  being  trans- 
mitted so  as  to  prove  a  prophylactic  [preventive]. 
He  was  aware  that  though,  as  a  rule,  persons  did 
not  have  small-pox  a  second  time,  yet  there 
are  instances  where,  from  peculiarity  of  con- 
stitution or  other  causes,  small-pox  occurs  a 
second  time  in  the  same  individual.  Such  con- 
siderations as  these  cheered  him  to  continue 
his  inquiries  when  apparent  exceptions  oc- 
curred to  the  protective  influence  of  true  cow- 
pox. 

Having  at  length  satisfied  his  own  mind, 
and,  indeed,  succeeded  in  con\dncing  others 
also,  respecting  the  important  protective  in- 
fluence exerted  on  the  constitutions  of  those 
who  had  received  the  true  cow-pox  in  the  casual 
30 


Jenner   and   Pasteur 

way,  he  sought  to  prove  whether  it  was  pos- 
sible to  propagate  the  disease  by  inoculation 
from  one  human  being  to  another.  On  the 
19th  May,  1796,  an  opportunity  occurred  of 
making  the  experiment.  Matter  was  taken  from 
the  hand  of  Sarah  Nelmes,  who  had  been  in- 
fected by  her  master's  cows,  and  inserted  into 
the  arm  of  James  Phipps,  a  health}^  boy  eight 
years  of  age.  He  went  through  the  disease 
in  a  regular  and  perfectly  satisfactory  way. 
But  was  he  secure  against  the  contagion  of 
small-pox?  It  is  needless  to  say  how  full  of 
anxiety  Jenner  was,  when  in  July  following 
he  put  this  to  the  test  by  inoculating  the  boy 
with  matter  taken  from  the  pustule  of  a  small- 
pox patient.  No  disease  followed  !  This,  his 
first  crucial  experiment,  Jenner  related  to  his 
friend  Gardner,  and  said:  "I  shall  now  pursue 
my  experiments  with  redoubled  ardour."  This 
ever-to-be-remembered  day,  19th  May,  1796, 
is  commemorated  by  an  annual  festival  in 
Berlin,  where,  in  18 19,  little  more  than  twenty 
years  after,  it  was  officially  reported  that  307,596 
persons  had  been  vaccinated  in  the  Prussian 
dominions  alone.  The  account  which  Jenner 
has  given  of  his  own  feelings  at  this  time  is 
deeply  interesting.  "While  the  vaccine  dis- 
covery was  progressing,"  he  says,  "the  joy  I 
felt  at  the  prospect  before  me  of  being  the 
instrument  destined  to  take  away  from  the 
world  one  of  its  greatest  calamities,  blended 
with  the  fond  hope  of  enjoj'ing  independence 
31 


Masterpieces   of   Science 

and  domestic  peace  and  happiness,  was  often 
so  excessive  that  in  pursuing  my  favourite  sub- 
ject among  the  meadows  I  have  sometimes 
found  m3^self  in  a  kind  of  reverie.  It  is  pleasant 
to  me  to  recollect  that  these  reflections  always 
ended  in  devout  acknowledgments  to  that 
Being  from  whom  this  and  all  other  mercies 
flow."  Ha\'ing  obtained  further  corroboration 
of  the  truth  of  his  conclusions  by  the  ^-accina- 
tion  of  his  own  son  and  several  others,  he  pub- 
lished in  the  form  of  a  quarto  pamphlet  called 
"An  Inquiry,"  a  brief  and  modest  but  com- 
plete account  of  his  investigations  and  dis- 
coveries. By  this  the  attention  of  the  whole 
medical  world  and  general  public  was  called 
to  the  subject.  His  doctrines  were  put  to  the 
test  and  abundantly  confirmed,  so  that  Mr. 
Clive,  the  celebrated  surgeon  of  the  day,  urged 
him  to  come  to  London,  and  promised  him  an 
income  of  ;^io,ooo  a  year.  Jenner,  however, 
declined  the  request,  saying,  "Admitting  as  a 
certainty  that  I  obtain  both  fortune  and  fame, 
what  stock  should  I  add  to  my  fund  of  little 
happiness  ?  And  as  for  fame,  what  is  it  ?  A 
gilded  butt  forever  pierced  by  the  arrows  of 
malignancy." 

Jenner  always  maintained  that  small-pox 
and  cow-pox  were  modifications  oi  the  same 
disease,  and  "^hat  in  eniploying  vaccine  lymph 
we  only  make  use  of  means  to  impregnate  the 
system  with  the  disease  in  its  mildest  form, 
instead  of  propagating  it  in  its  virulent  and 
32 


Jenner   and   Pasteur 

contagious  form,  as  is  done  when  small-pox  is 
inoculated.  He  felt,  also,  that  there  was  this 
objection  to  the  latter  practice,  which  had 
obtained  prevalence  since  its  introduction  to 
this  country  by  Lady  Mary  Wortley  Montagu, 
that  the  disease  was  thus  spread  among  the 
community.  He  had,  however,  at  that  time  to 
contend  against  the  prevalent  notions  that 
epidemic  diseases  affecting  the  human  race 
are  peculiar  to  man  and  have  no  influence  on 
the  lower  animals,  and  that  the  diseases  of 
other  animals  are  not  communicable  to  man. 
But  we  have  now  abundant  evidence  that  both 
these  notions  are  erroneous,  Jenner  himself, 
indeed,  had  shown  what  was  well  known  in 
various  parts  of  the  country,  that  the  "grease" 
of  the  heel  of  the  horse  was  frequently  com- 
municated to  those  who  had  the  care  of  horses, 
whether  or  not  it  was  the  same  disease  as  that 
which  affected  the  cow.  It  is  sufficient  only 
further  to  adduce  another  disease  of  horses, 
called  "farcy,"  which  is  not  infrequently  fatal 
to  grooms  and  others,  not  to  mention  the  still 
more  dreaded  hydrophobia  communicated  by 
dogs  and  animials  of  the  feline  species. 

The  rapid  acceptance  and  spread  of  Jenner's 
doctrines  speedily  silenced  all  cavillers  except 
that  small  minority  of  incredulous  and  fanat- 
ical opponents  who  are  always  to  be  found 
refusing  to  accept  any  truth  that  does  not  co- 
incide with  their  own  ignorant  and  prejudiced 
views.  The  frightful  mortality  and  appalling 
33 


^lasterpieces   of   Science 

effects  of  small-pox  prior  to  the  introduction  of 
vaccination  were  indeed  such  as  to  impell  men 
to  grasp  at  any  means  that  held  out  a  proba- 
bility of  escape  from  the  scoiirge.  In  the  present 
day  the  public  can  form  but  a  faint  idea  of  the 
ravages  of  small-pox  before  Tenner's  time.  The 
records  of  historians,  not  only  of  our  own  countn,\ 
but  throughout  the  world,  teem  with  the  most 
appalling  accoimts.  Dr.  Lettsom  calculated 
that  210,000  fell  victims  to  it  annually  in  Europe. 
Bemouilli,  an  Italian,  believed  that  not  less 
than  15.000.000  of  human  victims  were  de- 
prived of  life  by  it  ever\-  twenty-five  years, 
i.  e..  600,000  annually.  In  Russia  2.000,000  were 
cut  off  in  one  year.  In  Asia,  Africa,  and  South 
America,  whole  cities  and  districts  were  de- 
populated. Xor  Avas  it  only  the  actual  mortality 
which  rendered  it  so  appalling.  The  records 
of  the  Institution  for  the  Indigent  Blind  in  our 
own  countr\^  showed  that  three-foiirths  of  the 
objects  relieved  had  lost  their  sight  by  small- 
pox, while  the  number  of  persons  vnth  pitted 
and  scarred  faces  and  deformed  features  that 
were  met  with  in  the  streets  testified  to  the 
frightful  ordeal  that  they  had  passed  through. 
Multitudes  died  of  diseases  set  up  b^'  this  plague, 
or  from  ruined  constitutions  which  it  entailed. 
And  what,  of  all  this,  it  may  be  asked,  do  we 
now  see  ?  Is  it  not  a  rare  thing  to  meet  a  person 
whose  face  is  scarred  and  his  features  deformed 
by  smaU-pox?  How  few  persons  can  cite  in- 
stances among  their  acquaintance  of  those  who 
34 


Jenner  and   Pasteur 

have  died  of  small-pox  after  having  been  prop- 
erly vaccinated  ?  Is  it  necessary'  to  go  into 
statistics  and  elaborate  investigations  of  the 
bills  of  mortality  of  the  present  day  in  order 
to  be  convinced  that,  as  compared  with  the 
records  of  anti-vaccine  times,  we  have  indeed 
cause  to  bless  the  memory  of  Jenner  ? 

We  do  not  ignore  the  fact  that  small-pox, 
like  other  similar  diseases  having  an  epidemic 
character,  may  be  absent  for  a  length  of  time 
from  certain  districts  and  then  break  out  again; 
nor  that  each  epidemic  has  its  period  of  incre- 
ment and  decrement,  and  varies  in  its  degree 
of  malignancy.  But  a  full  and  careful  review 
of  the  whole  history  of  small-pox  since  the  in- 
troduction of  vaccination,  proves  to  every  un- 
prejudiced mind  that  every  recurring  epidemic 
finds  its  victims,  with  comparatively  few  ex- 
ceptions, among  the  unvaccinated,  that  its 
spread  is  arrested  by  renewed  attention  to 
vaccination  and  its  vigorous  enforcement,  and 
that,  even  taking  into  account  the  countries 
and  localities  where  from  various  causes  it 
has  been  neglected,  the  mortality  from  this 
foul  and  fatal  disease,  small-pox,  has  been  enor- 
mously reduced.  Human  lives  have  been 
saved,  and  human  Hfe  prolonged  to  such  an 
extent  that  it  is  impossible  to  estimate  the 
benefits  that  mankind  has  derived  from  the 
genius  and  devoted  patriotic  labours  of  one  man. 

That  doubts  and  difficulties  in  connection 
with  this  subject,  involving  the  well-being  of 
35 


Masterpieces   of   Science 

the  whole  human  race,  have  lately  arisen,  must 
be  admitted.  But  there  is  good  reason  to  be- 
lieve that,  by  modem  researches  on  the  sub- 
ject of  epidemic  diseases  and  the  geam  theory 
of  disease,  these  doubts  are  already  being  dis- 
pelled, and  that  the  difficulties  will  be  speedily 
ob\iated. 

The  grotmds  for  this  belief  will  be  tmder- 
stood  by  the  consideration  of  those  scientific 
investigations  to  a  brief  detail  of  which  we 
now  proceed.  The  reader  will  then  also  be  better 
able  to  judge  of  the  propriety  and  necessity 
of  certain  measures  which,  to  the  uninformed, 
must  appear  objectionable  or  even  repulsive 
and  arbitrary. 

We  now,  then,  turn  to  the  remarkable  experi- 
ments and  discoveries  of  M.  Pasteur,  which 
have  gained  for  him  a  world-wicie  reputation, 
and  the  bearing  of  which  on  the  science  of  pre- 
ventive medicine  is  commanding  the  attention 
and  admiration  of  the  whole  scientific  world, 
and  indeed  we  may  say  of  mankind  at  large. 
M.  Pasteur  is  not  a  medical  man,  nor,  indeed, 
a  physiologist.  He  is  simply  a  French  chemist, 
a  modest,  retiring  labourer  in  the  field  of  science 
whose  sole  object  has  been  the  discover}^  of 
truth,  and  whose  chemico-physical  researches 
gained  for  him  the  Rumford  Medal  of  the  Royal 
Society  in  1S56.  Ha\-ing  devoted  himself 
specially  to  the  chemistry  of  organic  substances, 
he  was  naturally  attracted  by  the  discover}^  of 
Cagniard  de  la  Tour,  that  yeast  is  really  a  plant, 
36 


Jenner   and   Pasteur 

a  species  of  fungus,  whose  vegetative  action 
in  fermentable  liquids  is  the  true  cause  of  their 
fermentation.  This  was  so  opposed  to  the 
theories  of  all  the  chemists  of  the  day,  among 
whom  may  particularly  be  mentioned  the  cele- 
brated Liebig,  that  it  met  with  their  warm 
opposition.  When,  however,  Helmholtz  and 
others  succeeded  in  showing  that  by  preventing 
the  passage  of  the  minute  organisms  consti- 
tuting the  yeast  plant  into  fermentable  liquids, 
no  fermentation  took  place,  the  doctrine  soon 
became  established  that  the  first  step  in  the 
process  of  alcoholic  fermentation  is  due,  not  to 
ordinary  chemical  changes,  but  to  the  presence 
of  living  organisms.  In  like  manner  the  putre- 
faction and  decomposition  of  various  liquids  con- 
taining organic  matter  was  found  to  be  due, 
not  to  the  simple  action  of  the  oxygen  of  the 
atmosphere,  but  to  the  introduction  from 
without  of  microscopic  germs  which  found 
material  for  their  development  in  such  liqtiids. 
So  that  if  by.  mechanical  filtration  of  the  air 
the  entrance  of  such  germs  can  be  prevented, 
or  if  by  heat  or  other  means  they  can  be  de- 
stroyed, any  fluid,  however  readily  it  may 
undergo  putrefaction  in  ordinary  circumstances, 
will  remain  perfectly  sweet,  though  freely  ex- 
posed to  the  air.  And  the  same  fluid  will  undergo 
a  different  kind  of  fermentation  according  as 
it  is  subjected  to  the  action  of  different  species 
of  germs.  These  and  other  facts  of  scarcely 
less  importance,  which  cannot  here  be  detailed, 
37 


Masterpieces   of  Science 

induced  Pasteur  to  test  the  application  of  the 
doctrines  deduced  from  them  to  the  study  of 
disease  in  living  animals. 

His  attention  was  first  directed  to  the  disease 
affecting  the  silkw^orm,  and  known  as  the  Pe- 
hrine,  which  at  one  time  seemed  likely  to  destroy 
the  silk  cultivation  both  in  France  and  Italy. 
It  had  been  ascertained  that  the  bodies  of  the 
silkworm,  in  all  its  stages  of  chr>^salis,  moth, 
and  worm,  were  in  this  disease  infested  by  mi- 
nute corpuscles  which  even  obtained  entrance 
into  the  undeveloped  eggs.  After  a  prolonged 
and  difficult  inquiry,  Pasteur  found  that  these 
minute  corpuscles  were  really  independent, 
self-propagating  organisms,  introduced  from 
without,  and  were  not  merely  a  sign  of  the 
disease,  but  its  real  cause.  As  a  result  of  the 
application  of  these  discoveries,  the  silkworm 
disease  has  been  extinguished,  or  so  controlled 
as  to  have  saved  a  most  important  and  valuable 
culture. 

Between  the  years  1867  and  1S70  above 
56,000  deaths  from  a  disease  variously  designated 
as  "anthrax,"  or  "carbuncular  disease,"  and 
"splenic  fever,"  and  in  France  known  by  the 
terms  "charbon,"  or  "pustule  maligne,"  are 
stated  to  have  occurred  among  horses,  cattle, 
and  sheep  in  one  district  of  Russia,  Novgorod, 
occasioning  also  the  deaths  of  528  among  the 
human  population.  It  occurs  in  two  foiTns, 
one  more  malignant  and  rapid  in  its  action 
than  the  other.  In  France  the  disease  appears 
38 


Jenner   and   Pasteur 

to  be  scarcely  ever  absent,  and  is  estimated 
to  entail  on  the  breeders  of  cattle  an  annual 
loss  of  many  millions  of  francs.  As  a  milder 
epidemic  it  has  prevailed  in  this  country,  and 
the  disease  which  has  lately  broken  out  in  Brad- 
ford and  some  other  towns  in  the  north  among 
wool-sorters,  has  now  been  shown  to  be  a  modi- 
fication of  the  same  disease  commimicated 
by  the  wool  of  sheep  that  have  been  infected. 
On  examining  the  blood  of  animals,  the 
subjects  of  "splenic  fever,"  some  French  path- 
ologists had  discovered  the  presence  of  certain 
minute  transparent  filaments  which,  by  the 
investigations  of  a  German  physician  named 
Koch,  were  proved  to  be  a  fungoid  plant  de- 
veloped from  germ  particles  of  microscopic 
minuteness.  By  gradual  extension  these  minute 
particles,  termed  "microbes,"  attain  the  form 
of  small  threads  or  rods,  to  which  the  name  of 
"bacilli"  has  been  given,  from  the  Latin  bacillus, 
a  rod  or  staff.  These  rods  were  found  to  be  in 
fact  hollow  tubes,  divided  at  intervals  by  par- 
titions, which,  on  attaining  full  growth,  break 
up  into  fragments,  the  interiors  of  which  are 
found  to  be  full  of  minute  germs  similar  to 
those  from  which  the  rods  were  at  first  devel- 
oped. These  germs  were  found  by  Koch  and 
his  collaborateurs  to  be  capable  of  cultivation 
by  being  immersed  in  some  suitable  organic 
liquid  kept  at  a  proper  temperature,  and  the 
supply  could  be  kept  up  by  introducing  even 
a  few  drops  of  such  impregnated  fluids  into  other 
39 


Masterpieces   of   Science 

fluids,  and  repeating  the  process  again  and 
again.  The  next  step  to  test  the  potency  of  these 
germs  to  generate  the  disease  in  animals  whence 
they  were  originally  obtained,  was  to  vacci- 
nate animals  Avith  a  few  drops  of  the  fluid  thus 
artificially  infected.  Accordingly  it  was  found 
that  the  bodies  of  guinea-pigs,  rabbits,  and 
mice  thus  inoculated  became  infected,  and 
developed  all  the  characteristic  symptoms  of 
splenic  fever  or  carbuncular  disease. 

Pasteur,  whose  enthusiasm  in  the  pursuit  of 
investigations  which  had  already  been  crowned 
■with  such  signal  success  kept  him  awake  to  all 
that  was  being  done  by  other  inquirers,  and 
made  him  watchful  of  every  event  that  trans- 
pired relative  to  the  epidemic  diseases  of  cattle, 
was  struck  with  the  fact  that  some  of  the  most 
fatal  outbreaks  of  "charbon"  among  flocks  of 
sheep  occurred  in  the  midst  of  apparently  the 
most  healthy  pastures.  His  sagacity  led  him 
to  inquire  what  had  been  done  ^vith  the  car- 
casses of  animals  that  had  died  from  pre\rious 
outbreaks  of  the  disease  in  these  localities,  when 
he  found  that  they  had  been  buried  in  the  soil 
and  often  at  great  depths,  of  the  same  pastures. 
But  how  could  the  disease  germs  make  their 
way  to  the  surface  from  a  depth  of  eight  or  ten 
feet  ?  Earthworms,  he  guessed,  might  have 
conveyed  them.  And  notwithstanding  the 
incredulity  wnth  which  his  explanation  was 
received,  he  forthwith  proceeded  to  verify  his 
supposition.  Having  collected  a  number  of 
40 


Jenner  and   Pasteur 

worms  from  the  ground  of  the  pastures  in  ques- 
tion, he  made  an  extract  of  the  contents  of  the 
alimentary  canal  of  the  worms,  and  with  this 
he  inoculated  rabbits  and  guinea-pigs,  gave  them 
the  "charbon"  in  its  most  fatal  form,  and  proved 
the  identity  of  the  malady  by  demonstrating 
that  the  blood  of  the  victims  swarmed  with  them 
deadly  "bacillus."  And  here  we  cannot  but 
stop  to  notice  the  remarkable  confirmation 
that  is  thus  given  to  the  wonderful  and  beautiful 
observations  of  Danvin  as  set  forth  in  his  last 
work  on  "The  Formation  of  Vegetable  Mould 
Through  the  Action  of  Worms."  Danvin  has 
shown  beyond  all  dispute,  as  the  result  of  his  in- 
comparable researches,  that  though  "the  plough 
is  one  of  the  most  ancient  and  most  valuable  of 
man's  inventions,  long  before  he  existed  the 
land  was  in  fact  regularly  ploughed,  and  still 
continues  to  be  ploughed,  by  earthworms." 
He  has  shown  us  that  the  smoothness  which 
we  admire  in  a  wide,  turf-covered  expanse  "is 
mainly  due  to  all  the  inequalities  having  been 
slowly  leveled  by  worms,"  and  that  "the  whole 
of  the  superficial  mould  over  any  such  expanse 
has  passed,  and  will  pass  again,  every  few 
years,  through  the  bodies  of  worms!"  It  was 
left  for  Pasteur  to  show  that  these  innumer- 
able and  indefatigable  plowmen,  whilst  render- 
ing to  man  such  efficient  service,  may  also  be  the 
carriers  of  the  seeds  of  disease  and  death. 

In  proceeding  with  our  brief  historical  account 
of  Pasteur's   and    allied  researches,   we   are   ar- 
41 


Masterpieces   of   Science 

rived  at  the  point  where  their  analog^'-  to  Jen- 
ner's  becomes  manifest,  and  where  their  direct 
bearing  on  the  welfare  of  mankind  comes  into 
view.  So  soon  as  it  was  kno'U'n  that  these  dis- 
ease germs  were  low  forms  of  vegetation,  and 
that,  like  other  vegetables,  they  could  be  cul- 
tivated, it  was  natural  to  ask  whether,  like 
other  vegetables,  their  characters  and  prop- 
erties could  not  be  so  modified  as  to  render 
them  at  least  less  deleterious.  Every  one  knows 
the  difference  between  the  crab- apple  and  its 
cultivated  variety,  the  sloe  and  the  plum,  the 
wild  and  the  cultivated  celery.  It  is  all  the 
difference  between  unwholesome  and  wholesome 
food. 

Two  methods  of  cultivation,  with  a  view 
to  obtaining  the  desired  modification  of  the 
power  exercised  by  the  bacilli  and  other  sim- 
ilar germs,  presented  themselves,  the  one  anal- 
ogous to  that  really  pursued  by  Jenner  where 
small-pox,  or  the  grease  of  the  horse,  was  passed 
through  the  system  of  the  cow,  and  then  from 
one  human  being  to  another;  and  the  second 
by  carrying  on  the  cultivation  out  of  the  li\dng 
body.  Both  these  plans  have  been  adopted, 
with  the  result  of  proving  that  the  potency  of 
the  germs  can  be  so  diminished  as  to  render  the 
disease  produced  by  their  introduction  so  mild 
as  to  be  of  no  importance.  Pasteur  cultivated 
the  bacillus  in  chicken  broth  or  meat  juice,  and 
allowed  a  certain  time  to  elapse  before  he  made 
use  of  the  mixture.  After  allowing  only  two 
42 


Jenner  and   Pasteur 

months  to  elapse,  the  \nrulence  of  the  germs 
seemed  to  be  but  Httle  impaired,  but  after  three 
or  four  months  animals  inoculated  with  the 
fluid,  though  they  took  the  disease,  had  it  in 
so  mild  a  form  that  the  greater  number  recov- 
ered. After  a  long  period  of  six  or  eight  months 
the  engendered  disease  was  so  mild  that  all 
the  animals  speedily  recovered  and  regained 
health   and  strength. 

And  now  the  question  will  naturally  arise, 
Did  animals  which  had  passed  through  the 
mild  disease  thus  induced  acquire  a  protection 
against  the  original  disease,  if  brought  in  con- 
tact with  it  in  subsequent  epidemics,  in  the 
same  way  that  Jenner's  vaccinated  patients 
were   protected   against   small-pox? 

An  answer  in  the  affirmative  may  now  be 
given  with  the  utmost  confidence.  Experiments 
conducted,  both  in  this  country  and  abroad, 
by  both  methods  of  procedure,  have  abun- 
dantly proved  that  animals  may  be  protected 
by  inoculation  so  as  to  render  them  insusceptible 
of  any  form  of  the  destructive  anthrax  disease. 

From  a  remarkable  paper  read  by  Pasteur 
before  the  International  Medical  Congress  we 
extract  the  concluding  paragraph.  After  de- 
tailing the  method  pursued  to  obtain  the  requi- 
site attenuation  of  the  virus,  and  stating  that 
by  certain  physiological  artifices  it  ma)^  be 
made  again  to  assume  its  original  virulence,  he 
proceeds:  "The  method  I  have  just  explained, 
of  obtaining  the  vaccine  of  splenic  fever,  was 
43 


Masterpieces   of   Science 

no  sooner  made  known  then  it  was  very  ex- 
tensively employed  to  prevent  the  splenic  affec- 
tion. In  France  we  lose  every  year  by  splenic 
fever  animals  to  the  value  of  20,000,000  francs, 
and  even,  according  to  one  of  the  persons  in 
the  office  of  the  Minister  of  Agriculture,  more 
than  30,000,000  francs,  but  exact  statistics  are 
still  wanting.  I  was  asked  to  give  a  public 
demonstration  at  Pouilly-le-Fort,  near  Melun, 
of  the  results  already  mentioned.  This  experi- 
ment I  may  relate  in  a  few  words.  Fifty  sheep 
were  placed  at  my  disposition,  of  which  twenty- 
five  were  vaccinated,  and  the  remaining  twenty- 
five  underwent  no  treatment.  A  fortnight 
afterwards  the  fifty  sheep  were  inoculated  with 
the  most  \-irulent  anthracoid  microbe  (or  germ) . 
The  twenty-five  vaccinated  sheep  resisted  the 
infection,  the  twenty-five  unvaccinated  died  of 
splenic  fever  -uathin  fifty  hours. 

"Since  that  time  the  capabilities  of  my  labora- 
tory have  been  inadequate  to  meet  the  demands 
of  farmers  for  supplies  of  this  vaccine.  In  the 
space  of  fifteen  days  we  have  vaccinated  in  the 
departments  surrounding  Paris,  more  than 
20,000  sheep,  and  a  large  number  of  cattle  and 
horses.  This  experiment  was  repeated  last  month 
at  the  Ferme  de  Lambert,  near  Chartres.  It 
deser\'es    special  mention. 

"  The  very  \nrulent  inoculation  practiced    at 

Pouilly-le-Fort,  in  order  to  prove  the  immunity 

produced  by  vaccination,  had  been  effected  by 

the  aid  of  anthracoid  germs  deposited  in  a  cul- 

44 


Jenner  and  Pasteur 

ture  which  had  been  preserved  in  my  labora- 
tory more  than  four  years,  that  is  to  say,  from 
the  2ist  March,  1877.  There  was  assuredly 
no  doubt  about  its  virulence,  since  in  fifty  hours 
it  killed  twenty-five  sheep  out  of  twenty-five. 
Nevertheless,  a  commission  of  doctors,  surgeons, 
and  veterinary-siu"geons,  of  Xhartres,  preju- 
diced with  the  idea  that  virus  obtained  from 
infectious  blood  must  have  a  virulence  capable 
of  defying  the  action  of  what  I  call  cultures  of 
virus,  instituted  a  comparison  of  the  effects 
upon  vaccinated  sheep  and  upon  unvaccinated 
sheep  of  inoculation  with  the  blood  of  an  animal 
which  had  died  of  splenic  fever.  The  result 
was  identical  with  that  obtained  at  Pouilly-le- 
Fort — absolute  resistance  of  the  vaccinated 
and  deaths  of  the  unvaccinated.  If  I  were  not 
pressed  for  time  I  should  bring  to  your  notice 
other  kinds  of  virus  attenuated  by  similar 
means.  These  experiments  will  be  communi- 
cated by-and-by   to   the  public." 

The  bearing  of  these  researches  of  Pasteur 
on  vaccination  with  cow-pox,  and  the  whole 
of  the  Jennerian  doctrines,  will  be  evident. 
They  throw  a  flood  of  light  both  on  the  efficacy 
of  vaccination  and  the  many  supposed  failures 
which  have  given  a  handle  to  the  unscrupulous 
fanatical  detractors  of  Jenner  and  his  doctrines. 
They  go  far  toward  establishing  the  correct- 
ness of  the  view  entertained  by  Jenner  as  to 
the  identity  of  small-pox  and  cow-pox,  showing 
how  great  may  be  the  modifications  effected 
45 


Masterpieces   of   Science 

in  the  original  virus  by  repeated  transmission, 
either  through  the  animal  or  the  human  system. 
But  apart  from  the  question  of  identity  or 
diversity  of  small-pox  and  vaccinia,  Pasteur's 
researches  prove  beyond  all  question  that  a 
disease  \'irus  m^ay  be  both  diminished  and 
augmented  in  power  by  physiological  devices, 
and  that  therefore  the  efficacy  of  the  vaccine 
lymph  may,  in  various  ways,  be  so  diminished 
as  to  lose  its  protective  power,  without  shaking 
our  faith  in  the  principle  of  vaccination  or 
detracting  in  the  least  from  the  inestimable 
value  of  Jenner's  discovery.  The  attention  of 
the  scientific  world  will  now  be,  and  is,  directed 
to  the  important  inquiry,  How  far  has  the 
original  vaccinia  of  Jenner  lost  its  protective 
power?  If  so,  how  has  this  been  brought  about, 
and  by  what  means  can  it  be  restored?  Must 
we  again  revert  to  the  cow  for  a  new  supply? 
Need  we  only  be  more  scrupulous  in  the  se- 
lection of  the  vesicles,  and  the  particular  stage 
of  their  development,  and  in  the  mode  in  which 
the  operation  of  vaccination  is  performed? 
These  and  numerous  other  similar  questions  are 
now  being  discussed  and  investigated,  but 
none  probably  is  more  important  than  the 
question  how  far  the  protective  influence  in 
each  individual  is  dissipated  by  time,  and  hence 
the  principle  of  re-vaccination  is  now  being 
enforced.  There  can  be  no  doubt  that  different 
epidemics  possess  different  degrees  of  virulence, 
and  what  proves  a  sufficient  protection  in  a 
46 


Jenner  and  Pasteur 

mild  epidemic  of  small-pox  may  not  be  sufficient 
in  a  more  virulent  one.  In  certain  seasons  and 
in  certain  conditions  of  the  atmosphere,  the 
human  system  is  more  prone  to  certain  disease 
than  at  other  times.  Pasteur's  experiments  on 
cultivated  virus  or  germs  show  that  in  the 
course  of  time,  and  in  certain  conditions  of  ex- 
posure to  the  action  of  oxygen  or  other  agents, 
the  vitality,  or  constitution,  so  to  speak,  of  the 
germs  may  be  so  changed  as  materially  to  alter 
their  action  on  the  animal  system.  We  have, 
therefore,  scientific  grounds  for  reverting  from 
time  to  time  to  the  heifer  for  a  new  stock,  rather 
than  continuing  to  rely  on  the  perpetual  trans- 
mission   from   one   human   body   to    another. 

This  is  not  the  place  to  enter  on  the  whole 
question  of  the  germ  theory  of  disease,  but  who 
does  not  see  how  wide  is  the  field  for  investi- 
gation opened  up  by  Pasteur  and  others?  Al- 
ready the  application  of  the  principle  of  vacci- 
nation has  been  successfully  applied  by  Pasteur 
to  a  very  fatal  epidemic  disease  attacking  fowls, 
and  known  by  the  name  of  "chicken  cholera." 
By  inoculating  chickens  with  the  cultivated 
variety  of  the  particular  "bacillus"  he  has 
afforded  to  them  complete  protection.  The 
economic  value  of  this  to  France  may  in  some 
measure  be  estimated  by  the  many  millions  of 
eggs  which  are  exported  from  France  to 
this  country  alone.  How  many  other  diseases, 
such  as  scarlatina  and  diphtheria,  which  now 
carry  off  annually  thousands  of  children,  may 
47 


Masterpieces   of   Science 

not  ere  long  be  extinguished  by  like  means  who 
shall  say?  "I  venture,"  states  Mr.  Simon,  in 
his  address  to  the  Health  Section  of  the  Inter- 
national Congress,  "to  say  that  in  the  records 
of  human  industry  it  would  be  impossible  to 
point  to  work  of  more  promise  to  the  world 
than  these  various  contributions  to  the  knowl- 
edge of  disease  and  of  its  cure  and  prevention, 
and  they  are  contributions  which,  from  the 
nature  of  the  case,  have  come,  and  could  only 
have  come,  from  the  performance  of  experi- 
ments on  living   animals." 

Compulsory  vaccination  is,  no  doubt,  a  strong 
measure,  and  one  which  might,  in  this  land 
of  individual  liberty,  be  expected  to  give  rise 
both  to  question  and  opposition.  It  can  only 
be  justified  by  proving  that  it  is  to  the  interest  of 
the  individual  as  well  as  of  the  whole  community 
that  it  should  be  enforced.  Of  its  propriety 
and  necessity  we  believe  it  needs  only  a  calm 
and  unprejudiced  inquiry  to  be  convinced. 
Most  of  the  objections  raised  against  it  are 
either  baseless  or  admit  of  being  obviated. 
That  some  of  the  objections  are  of  a  character 
that  command  our  respect  may  be  admitted, 
but  mere  sentiment  or  prejudiced  and  ill-founded 
objections,  must  give  place  to  sound  arguments 
and  well-established  evidence.  In  this,  as  in 
many  similar  cases,  opposition  and  discussion 
open  up  entrances  for  light  by  which  the  clouds 
of  ignorance  and  darkness  are  sure  to  be  dis- 
pelled. But  even  as  this  whole  question  of 
48 


jenner  and  Pasteur 

vaccination  now  stands,  the  responsibility  of 
those  who  are  persistently  misrepresenting  facts 
and  misleading  the  public  is  great,  nay,  crimi- 
nal, when  we  reflect  how  many  lives  are  sacri- 
ficed by  the  neglect  of  precautionary  means 
within  the  reach  of  all. 


49 


LOUIS  PASTEUR  AND  HIS  WORK 
Patrick  Geddes  and  J.  Arthur  Thomson 

[Professor  Geddes  is  Professor  of  Botany  at  University 
College,  Dundee.  He  has  written  "Chapters  in  Modern 
Botany"  and  many  botanical  articles  and  papers.  Professor 
Thomson  is  Regius  Professor  of  Natural  History,  Aberdeen 
University.  His  works  include  "The  Study  of  Animal 
Life,"  "Outlines  of  Zoology,"  "The  Natural  History  of  the 
Year"  and  "The  Science  of  Life."  "The  Evolution  of  Sex" 
was  written  jointly  by  both  these  authors.  The  article 
from  which  extracts  follow  was  published  in  the  Contem- 
porary Review,  1895:  the  editor's  permission  to  reprint  is 
gratefully  acknowledged.  The  Life  of  Louis  Pasteur  by  M. 
Radot,  2  vols.,  were  published  by  McClure,  Phillips  &  Co., 
New  York,  1901.O 

The  course  of  Pasteur's  scientific  work  is  one 
of  remarkably  natural  and  logical  sequence. 
As  the  veteran  M.  Chevreuil  long  ago  said  in 
the  Academy  of  Sciences,  "It  is  by  first  exam- 
ining in  their  chronological  order  the  researches 
of  M.  Pasteur,  and  then  considering  them  as  a 
whole,  that  we  appreciate  the  rigor  of  his  con- 
clusions, and  the  perspicacity  of  a  mind  which, 
strong  in  the  truths  which  it  has  already  dis- 
covered, sweeps  forward  to  the  establishment 
of  what  is  new."  We  shall  therefore  summarize 
the  record  of  his  greatest  achievements. 

As  was  natural  in  a  pupil  of  Dumas,  Balard, 

and   Delafosse,    Pasteur's  first   important  piece 

of  work  was  chemical  and  crystallographic,  and 

we  may  best  understand  its  spirit  by  recalling 

51 


Masterpieces   of   Science 

the  work  of  Delafosse's  master  in  mineralogy', 
the  Abbe  Hauy,  who  is  still  remembered  for 
that  bold  attempt  to  visualize  the  ultimate 
structure  of  the  crj'stal,  to  penetrate  the  inmost 
secret  of  its  architecture,  which  also  re-appears 
in  another  way  in  the  work  of  Mendeljefi. 
Pasteur's  puzzle  concerned  the  tartrates  and 
paratartrates  of  soda  and  ammonia.  These 
two  salts  are  alike  in  chemical  composition,  in 
cr^-staUine  form,  in  specific  gra^-it}',  and  so  on, 
but  they  differ  in  beha\'iour.  Thus,  as  Biot  had 
shown,  a  solution  of  tartrate  deflects  the  plane 
of  polarized  light  passed  through  it,  while  a 
solution  of  the  paratartrate  does  not.  The  salts 
are  the  same,  yet  the}'  behave  differently.  A 
note  to  the  Academy  from  the  famous  chemist 
Mitscherlich  emphasized  the  entire  similarity 
of  the  two  salts,  and  this  acted  as  an  additional 
stimulus  to  Pasteur.  He  succeeded  in  distinguish- 
ing the  minute  facets  which  even  ^litscherlich  had 
missed;  he  proved  that  the  paratartrate  is  a 
combination  of  a  left-handed  and  a  right-handed 
tartrate,  and  did  much  else  which  only  the  ex- 
pert chemist  could  duly  explain.  Biot  was 
first  doubtful,  then  delighted;  Arago,  who  had 
also  busied  himself  with  these  matters,  moved 
that  Pasteur's  paper  be  printed  in  the  memoirs 
of  the  Academy,  and  Mitscherlich  himself  con- 
gratulated the  yoimg  discoverer  who  had  tripped 
him  up. 

Already,  then,  in  this  minute  and   laborious 
piece  of  work,  we  may  detect  ultra-microscopic 
52 


Louis    Pasteur   and    His    Work 

mental  vision,  and  that  rigorous  accuracy  so 
characteristic  of  the  man.  Yet  it  is  interesting 
to  observe  that  at  this  early  stage  he  was  sow- 
ing his  wild  oats  of  speculation.  Impressed  by 
the  strange  rotation  of  the  plane  of  polarization 
exhibited  by  these  organic  salts,  he  deduced 
therefrom  an  hypothesis  of  molecular  disym- 
metry,  and  hazarded  the  view  that  this  was  a 
fundamental  distinction  between  the  organic  and 
the  inorganic.  For  various  reasons,  neither 
chemist  nor  biologist  would  nowadays  accept 
this  distinction ;  but  it  is  hard  to  tell  what  Pasteur 
might  have  made  of  this  inquiry  had  not  cir- 
cumstances, regretted  at  the  time,  directed  his 
attention  to  very  different  subjects. 

Being  thus  known  in  connection  with  tar- 
trates, Pasteur  was  one  day  consulted,  so  the 
story  goes,  by  a  German  manufacturer  of  chem- 
icals, who  was  puzzled  by  the  fermentation  of 
his  commercial  tartrate  of  lime,  which  con- 
tained some  admixture  of  organic  impurities. 
Pasteur  undertook  to  look  into  the  matter,  and 
probably  deriving  some  hint  from  the  previous 
work  of  Cagniard  Latour,  and  Schwann  who 
had  demonstrated  the  yeast-plant  which  causes 
alcoholic  fermentation,  he  demonstrated  the 
micro-organism  which  fermented  the  tartrate 
of  lime.  He  extended  this  discovery  to  other 
tartrates,  and  made  the  neat  experiment  of 
showing  how  the  common  blue  mould  (Penicil- 
Ihmi  glaucum) ,  sown  in  paratartrate  of  ammonia, 
uses  up  all  the  right-handed  tartrate  and 
53 


Masterpieces   of   Science 

leaves  the  left-handed  salt  alone,  its  iden- 
tical chemical  composition  notwithstanding. 
These  and  similar  inquiries  led  him  to  tackle  the 
whole  question  of  fermentation,  but  his  trans- 
ference to  Lille  had  probably  much  to  do  with 
this.  For,  as  one  of  the  chief  industries  of  the 
district  is  making  alcohol  from  beet-root  and 
grain,  Pasteur's  practical  sense  led  him  to  devote 
some  of  his  lectures  to  fermentation;  here,  as 
always,  as  his  biographer  reminds  us,  wishful 
to  make  himself  directly  useful  to  his  hearers. 

The  prevalent  theor\^  of  fermentation,  before 
Pasteur  took  the  subject  in  hand,  was  that  of 
Willis  and  Stahl,  revised  and  elaborated  by 
Liebig.  According  to  this  theor}',  nitrogenous 
substances  in  a  state  of  decomposition  upset  the 
molecular  equilibrium  of  fermentable  matter 
with  which  they  are  in  contact.  What  Pasteur 
did  was  to  show  that  lactic,  butyric,  acetic,  and 
some  other  fermentations,  were  due  to  the  vital 
acti\dt3^  of  micro-organisms.  In  spite  of  Liebig 's 
prolonged  opposition,  Pasteur  carried  his  point; 
and  although  some  of  his  detailed  interpreta- 
tions have  since  been  revised,  it  is  tmiversally 
admitted  that  he  changed  the  whole  complexion 
of  the  fermentation  problem.  It  must,  of  course. 
be  borne  in  mind  that  his  theor}^  of  the  vital 
nature  of  many  fermentations  does  not  apply 
to  soluble  ferments  or  enzymes — such  as  diastase 
and  pepsin — which  are  chemical  substances,  not 
living  organisms.  Part,  indeed,  of  the  opposi- 
tion to  Pasteur's  \news  was  due  to  the  fact  that 
54 


Louis    Pasteur    and    His    Work 

this  distinction  between  organized  and  unor- 
ganized ferments  was  not  at  the  time  clearly 
drawn.  Perhaps,  indeed,  we  are  as  yet  by  no 
means  out  of  the  woods. 

In  the  course  of  his  work  on  fermentation, 
Pasteur  made  an  important  theoretical  step  by 
distinguishing  the  micro-organisms  which  re- 
quire the  presence  of  free  oxygen,  from  forms 
which  are  able  to  live  apart  from  free  oxygen, 
obtaining  what  they  require  by  splitting  up 
oxygen-containing  compounds  in  the  surroimd- 
ing  medium.  These  he  termed  aerobic  and 
anaerobic  respectively.  Practically,  this  piece 
of  work  immediately  led  to  what  is  known  as 
the  Orleans  process  of  making  vinegar.  Some 
years  later,  after  he  had  returned  to  Paris,  he 
followed  this  up  by  his  studies  on  wine,  in  the 
course  of  which  he  tracked  various  wine-diseases 
to  their  sources,  and  showed  how  deterioration 
might  be  prevented  by  raising  the  wine  for  a 
minute  to  a  temperature  of  50°  C.  The  wine- 
tasters  of  Paris  gave  their  verdict  in  his  favour. 

The  old  notion  of  spontaneous  generation  still 
lingered  in  some  quarters,  and  in  1858  Pouchet 
had  given  new  life  to  the  question  by  claiming 
before  the  Academy  of  Sciences  that  he  had 
succeeded  in  proving  the  origin  of  microscopic 
organisms  apart  from  pre-existing  germs.  But 
Pasteur  knew  more  than  Pouchet  as  to  the  in- 
sidious ways  of  germs:  he  showed  the  weak 
point  of  his  antagonist's  experiments,  and 
gained  the  prize,  offered  in  i860  by  the  Academy, 
55 


]\Iasterpieces   of   Science 

for  'Veil-contrived  experiments  to  throw  new 
light  upon  the  question  of  spontaneous  genera- 
tion." As  every  one  knows,  the  victory  was 
with  Pasteur,  but  the  idea  is  an  old  and  recur- 
rent one,  and  dies  hard.  Thus,  not  many  years 
afterward,  Pasteur  and  Tyndall  had  to  fight  the 
battle  over  again  with  Bastian.  The  important 
result  of  what  seems  at  first  sight  an  abstract  dis- 
cussion has  been  not  only  an  increased  knowledge 
of  the  distribution  and  dissemination  of  bac- 
teria, but  the  establishment  of  the  fundamental 
conditions  and  methods  of  experimental  bac- 
teriology.     .     . 

[Here  follows  substantially  the  same  narrative 
as  that  given  by  Sir  J.  Risdon  Bennett  on  pages 
36  to  49  of  this  volume.  It  recites  how  Pas- 
teur devised  preventives  for  the  disease  which 
was  destroying  the  silk^'orms;  preventives  for 
splenic  fever  or  anthrax.] 

Opposition  was  an  ever-recurrent  factor  in 
Pasteur's  life.  He  had  to  fight  for  his  cr}-stal- 
lographic  and  chemical  theories,  and  for  his  fer- 
mentation theory;  he  had  to  fight  against  the 
theory  of  spontaneous  generation,  and  for  his 
practice  of  inoculating  as  a  preventive  against 
splenic  fever;  he  had  to  fight  for  each  step.  But 
no  part  of  his  work  has  met  with  so  much  op- 
position and  adverse  criticism  as  that  concerning 
hydrophobia,  though  it  is  easy  to  exaggerate  the 
importance  of  the  discussion,  in  which  Pasteur 
himself  took  little  part.  Feeling  ran  high  in 
this  country;  hence,  when  it  was  annotinced 
56 


Louis    Pastetir    and    His   Work 

that  Pasteur — surely  best  qualified  to  speak — 
was  to  write  the  article  Hydrophobia  in  "Cham- 
ber's Encyclopaedia,"  a  shower  of  letters  inun- 
dated the  office;  hence  the  article  in  question 
includes  an  editorially  demanded  summary  of 
the  grounds  of  the  opposition  by  one  of  our- 
selves, and  to  which  therefore  we  may  refer  the 
reader. 

While  avoiding  controversy  and  partisanship 
as  far  as  may  be,  the  question  remains.  What 
did  Pasteur  do  in  regard  to  hydrophobia  ?  His 
claims  are  to  have  proved,  first  of  all,  that  the 
disease  v/as  particularly  associated  with  the 
nervous  system.  The  virus  is  usually  spread 
through  the  saliva,  but  it  is  not  found  in  the 
blood  or  lymph,  and  it  has  its  special  seat  in 
the  nerves,  brain,  and  spinal  cord.  Secondly, 
he  showed  that  the  virus  might  be  attenuated 
in  its  virulence.  The  spinal  cord  of  a  rabbit 
which  has  died  of  rabies,  is,  when  fresh,  power- 
fully virulent,  but  when  exposed  for  a  couple 
of  weeks  to  dry  air  at  a  constant  temperature 
of  23°-24°  C.  it  loses  its  virulence.  Thirdly,  he 
showed  that  inoculation  with  the  attenuated 
virus  rendered  an  animal  immune  from  infection 
with  rabies.  To  make  the  animal  immune  it 
has  first  to  be  inoculated  with  infected  spinal 
cord  fourteen  days  old,  then  with  that  of  thir- 
teen days,  and  so  on  till  inoculation  with  almost 
freshly  infected  spinal  cord  is  possible.  In  this 
way  the  animal  becomes  refractory  to  the  in- 
fection, and  if  it  be  bitten  it  will  not  die.  Fourth- 
57 


Masterpieces   of   Science 

ly,  he  showed  that  even  if  the  organism  had 
been  bitten,  it  was  still  possible  to  save  it,  unless 
the  wounds  were  near  the  head — that  is,  within 
close  reach  of  the  central  ner\'ous  system.  For 
in  the  case  of  a  superficial  wound,  say  on  hand  or 
leg,  the  \-irus  takes  some  considerable  time  to 
spread,  and  during  this  period  of  spreading  and 
incubation  it  is  possible  to  forestall  the  virus  by 
inoculation  with  that  which  has  been  attenu- 
ated. In  this  case  there  is  ob\-ious  truth  in  the 
proverb,"  He  gives  twice  who  gives  quickl}'." 
And  the  outcome  was,  that  while  out  of  a  hun- 
dred persons  bitten,  nineteen  or  twenty  will 
in  ordinar\^  circumstances  die,  "the  mortality 
among  cases  treated  at  the  Pasteur  Institute  has 
fallen  to  less  than  1-2  per  cent."  According  to 
another  set  of  statistics,  a  mortality  of  40  per 
cent,  has  been  reduced  to  1.3  per  cent.;  and  of 
1673  patients  treated  by  Pasteur's  method  only 
thirteen  died. 

As  to  the  adverse  criticism  of  Pasteur's  inocu- 
lation against  rabies,  it  consists,  first  and  second, 
of  the  general  argument  of  the  anti-vaccina- 
tionists,  and  thirdly,  of  specific  objections.  To 
the  two  former  the  school  of  Pasteur,  of  course, 
replies  that  the  value  of  human  life  answers  the 
one,  and  the  results  of  experience  the  other; 
but  on  these  controversies  we  cannot  enter  here. 
The  main  specific  objections  we  take  to  be  three — 
that  as  the  micro-organism  of  rabies  has  not 
really  been  seen,  the  theory'  and  practice  of 
Pasteur's  anti-rabic  method  lack  that  stability 
58 


Louis    Pasteur    and    His    Work 

which  is  desirable ;  that  the  statistics  in  favor  of 
the  Pasteur  procedure  have  been  insufficiently- 
criticised;  that  there  have  been  failures  and 
casualties,  sometimes  of  a  tragic  nature.  In 
regard  to  this  last  point — that  deaths  have  oc- 
curred as  the  result  of  the  supposed  cure,  in- 
stead of  from  the  original  infection — ^we  may- 
note  that  the  possibility  of  such  casualties  was 
admitted  by  the  English  Investigation  Com- 
mittee (1887),  while,  on  the  other  hand,  Dr. 
Armand  Ruffer,  who  speaks  with  much  authority, 
denies  with  all  deliberateness  that  there  is  any 
known  case  in  which  death  follov/ed  as  the  re- 
sult of  Pasteur's  treatment. 

Microscopic  verification  is,  of  course,  most 
desirable,  and  statistics  are  proverbially  diffi- 
cult of  criticism.  But,  on  the  whole,  we  think 
it  likely  that  those  who,  like  ourselves  are  not 
medical  experts  will  incline  to  believe  that  Sir 
James  Paget,  Dr.  Lauder  Brunton,  Professor 
George  Fleming,  Sir  Joseph  Lister,  Dr.  Richard 
Quain,  Sir  Henry  Roscoe,  and  Professor  Burdon 
Sanderson  must  have  had  grounds  for  say- 
ing, in  the  report  which  they  presented  to  Parlia- 
ment in  1887,  "It  may,  hence,  be  deemed  cer- 
tain that  M.  Pasteur  has  discovered  a  method 
of  protection  from  rabies  comparable  with  that 
which  vaccination  affords  against  infection  from 
small-pox." 

So  far  a  summary  of  Pasteur's  personal  life 
and  scientific  work,  but  is  it  not  possible  to  make 
a  more  general  and  rational  estimate  of  these? 
59 


^Masterpieces   of   Science 

So  much  was  his  Hfe  centred  in  Paris  that  most 
peopla  are  probably  accustomed  to  think  of  him 
as  a  townsman ;  but  it  is  more  biologically  accurate 
to  recognize  him  as  a  rustic,  sprung  from  a 
strong,  thrifty  stock  of  mountain  peasants. 
Nor  can  his  rustic  early  en\4ronment  of  tanyard 
and  farm,  of  \'illage  and  countr^'-side,  be  over- 
looked as  a  factor  in  developing  that  practical 
sense  and  economic  insight  which  were  so  con- 
spicuous in  his  life  work.  The  tanner's  son 
becomes  the  specialist  in  fermentation;  the 
country  boy  is  never  throughout  his  life  beyond 
hail  of  the  poultrj'-yard  and  the  farm-steading, 
the  wine  press  and  the  silk  nurser^^;  brought  up 
in  the  rural  French  atmosphere  of  careftil  thrift 
and  minute  economies,  all  centred  not  round 
the  mechanism  or  exchange  of  town  industries, 
but  round  the  actual  maintenance  of  human 
and  organic  life,  he  becomes  a  great  life-saver 
in  his  generation. 

In  short,  as  we  might  almost  diagrammatically 
sum  it  up,  the  shrewd,  minutely  careful,  3-et  in- 
quiring rustic,  eager  to  understand  and  then  to 
improve  what  he  sees,  passes  in  an  ever-widen- 
ing spiral  from  his  rural  centre  upward,  from 
tan-pit  to  vat  and  \'intage,  from  manure- 
heaps,  earthworms,  and  water-supply  to  the 
problems  of  civic  sanitation.  The  rustic 
tragedies  of  the  dead  cow  and  the  mad 
dog  excite  the  explanation  and  suggest  the 
prevention  of  these  disasters;  from  the  poison- 
ing of  rats  and  mice  he  passes  to  suggestive 
60 


Louis    Pasteur    and    His    Work 

experiments  as  to  the  rabbit-pest  of  Australia-, 
and  so  in  other  cases  from  beast  to  man,  from 
village  to  state.  And  on  each  radius  on  which 
he  paused  he  left  either  a  method  or  a  clew,  and 
set  some  other  inquirer  at  work.  On  each 
radius  of  work  he  has  left  his  disciples;  for  he 
founded  not  only  an  Institute,  but  a  living 
school,  or  indeed  whole  schools  of  workers.  We 
think  of  him,  then,  not  only  as  thinking  rustic, 
but  as  one  of  the  greatest  examples  in  science 
of  the  Rustic  Thinker — a  type  of  thinker  too 
rare  in  our  mechanical  and  urban  generation, 
yet  for  whom  the  next  generation  waits. 

As  to  his  actual  legacy  to  the  world,  let  us 
sum  it  up  briefly.  There  is  the  impulse  which 
he  gave,  after  the  successful  organization  of  his 
own  Institute,  to  the  establishment  in  other 
countries  of  similar  laboratories  of  preventive 
medicine,  and,  one  may  also  say,  of  experimental 
evolution.  There  is  his  educative  work  at 
Strasburg  and  Lille,  at  the  Ecole  Normale  and 
the  Sorbonne,  and,  above  all,  in  the  smaller 
yet  world-wide  circle  of  his  immediate  disciples. 
To  general  biology  his  chief  contribution  has 
been  the  demonstration  of  the  part  which  bac- 
teria play,  not  only  in  pathological  and  physio- 
logical processes,  but  in  the  wider  drama  of  evo- 
lution. To  the  chemist  he  has  given  a  new 
theory  of  fermentation;  to  the  physician  many 
a  stiggestive  lesson  in  the  etiology  [inquiry 
into  the  causes]  of  diseases,  and  a  series  of  bold 
experiments  in  preventive  and  curati\'e  in- 
6i 


Masterpieces   of   Science 

oculation,  of  TV'hlch  Roux's  treatment  of  diph- 
theria and  Professor  Eraser's  new  remedy  for 
snake-bite  are  examples  at  present  before  the 
public;  to  the  surgeon  a  stable  foundation,  as 
Lister  acknowledged,  for  antiseptic  treatment; 
to  the  hygienist  a  multitude  of  practical  sug- 
gestions concerning  water-supply  and  drainage, 
disinfection  and  burial.  On  brewer,  distiller, 
and  wine-maker  he  has  forced  the  microscope 
and  its  results;  and  he  has  shown  both  agricul- 
turist and  stock-breeder  how  some,  at  least,  of 
their  many  more  than  ten  plagues  may  be  either 
averted  or  alle\'iated. 


63 


TUBERCULOSIS   AND    ITS    PREVENTION 
T.  Mitchell  Prudden,  M.  D. 

[Dr.  Prudden  is  Professor  of  Pathology  in  the  College  of 
Physicians  and  Surgeons,  New  York.  He  has  bestowed 
especial  attention  upon  the  means  of  preventing  disease:  in 
that  important  field  he  has  written  three  capital  manuals, 
all  published  by  G.  P.  Putnam's  Sons,  New  York: —  "Story 
of  the  Bacteria,"  "Dust  and  Its  Dangers,"  "Water  and  Ice 
Supplies."  His  other  works,  intended  for  the  professional 
reader,  are  of  the  highest  authority.  The  article  here  given 
appeared  in  Harper's  Magazine,  March,  1894;  copyright  by 
Harper  &  Brothers,  who  have  granted  permission  to  reprint. 
In  May,  1902,  these  pages  were  revised  by  Dr.  Prudden  .0 

It  is  commonly  neither  wise  nor  necessary 
for  people  not  professionally  concerned  to 
think  much  about  disease,  or  weigh  anxiously 
the  chance  or  mode  of  its  acquirement.  But 
now  and  then  conditions  arise  which  demand 
general  attention  and  instruction  regarding  cer- 
tain diseases  in  order  that  a  great,  threatening 
calamity  may  be  averted.  Such  a  condition 
faces  the  people  in  all  lands  to-day  in  the  ap- 
palling prevalence  of  tuberculosis.  A  disease 
which  in  mild  or  severe  form  affects  at  least 
one-half  of  the  whole  human  race,  and  which 
causes  the  death  of  full  one-seventh  of  all  who 
pass  away,  killing  about  one-third  of  those 
who  perish  between  the  ages  of  fifteen  and 
forty-five — a  disease  which  is  most  insidious 
63 


Masterpieces   of   Science 

in  its  onset,  and  often  relentless  in  its  course, 
and  which  may  be  largely  prevented — is  one 
about  which  we  cannot  be  indifferent,  and 
should  not   be   longer  inactive. 

There  has  long  been  reason  for  believing  that 
tuberculosis  is  a  communicable  disease.  Its 
prevalence  in  certain  families  and  communities, 
its  frequent  occurrence  in  those  who  have  per- 
sonally attended  upon  its  victims,  its  onset  in 
those  who  have  occupied  apartments  vacated 
by  consumptives — such  facts  obser\-ed  over  and 
over  again  abimdantly  justify-  the  belief  in  its 
communicability.  Up  to  the  commencement 
of  the  last  decade  the  cause  of  the  disease  was 
altogether  unkno-^-n,  and  no  definite  data  were 
at  hand  which  could  enable  us  to  fix  upon  a 
feasible  plan  for  limiting  its  ravages.  But  in 
these  later  years  a  great  light  has  been  thro^^^l 
upon  this  and  other  kindred  diseases. 

Most  intelligent  people  are  aware  that  within 
the  past  decade  a  new  field  in  the  domain  of 
life  has  been  revealed  and  widely  explored.  It 
has  been  learned  that  in  earth  and  air  and 
water  there  exist  coimtless  myriads  of  lix-ing 
things  so  minute  as  to  lie  far  beyond  the  limits 
of  the  unaided  vision,  and  yet  in  the  aggregate 
so  potent  in  the  maintenance  of  the  cycle  of 
life  upon  earth  that  without  their  activity 
all  life  would  soon  cease  to  be.  and  the  ele- 
ments which  for  a  short  span  fall  under  the 
sway  of  the  life  forces  in  all  higher  animals  and 
plants  would  lapse  finally  and  irrevocably 
64 


Tuberculosis    and    Its    Prevention 

into  their  primal  state.  These  tiny  organisms 
are  called  germs,  microbes,  or  micro-organ- 
isms. One  great  and  important  group  of  them 
belongs  among  the  microscopic  plants  called 
bacteria.  These  bacteria  as  a  class  are  im- 
portant in  their  economy  of  nature,  because 
they  live  for  the  most  part  on  dead  organic 
material — that  is,  such  material  as  has  once 
formed  a  portion  of  some  living  thing. 

The  world's  store  of  available  oxygen,  hy- 
drogen, carbon  and  nitrogen,  out  of  which  all 
living  beings  are  largely  formed,  is  limited,  and 
if  after  these  have  served  their  temporary  uses, 
as  the  medium  through  which  that  mysterious 
potency  called  life  alone  can  find  expression, 
they  were  not  speedily  released,  new  generations 
of  living  beings  could  neither  assume  nor  main- 
tain their  place  in  the  great  cycle  of  life.  And 
so  these  tin}^  plants,  year  in,  year  out,  by  day 
and  by  night,  unseen  and  mostly  unheeded, 
are  busy  always  in  making  possible  the  return 
of  each  year's  visible  vegetation  and  the  main- 
tenance of  an  unbroken  succession  of  generations 
in  man  and  beast. 

Different  groups  and  races  among  the  bacteria 
have  different  habitations,  and  vary  widely  in 
their  special  powers.  Complex  and  powerful 
as  is  the  aggregate  result  which  they  accom- 
plish in  the  world,  the  performances  of  the 
individual  are  comparatively  simple.  They  are 
most  liberally  endowed  with  the  capacity  for 
multiplication,  and  each  germ  acts  as  a  tiny 
65 


Masterpieces   of   Science 

chemical  laboratorv',  taking  into  itself  the  or- 
ganic matter  on  which  it  feeds,  and  resoh-ing 
it  into  new  compounds.  Some  of  the  latter  are 
used  in  building  up  and  maintaining  its  own 
body,  while  others  are  given  off  into  the  sur- 
rounding media. 

We  are  but  just  beginning  to  peer  at  the 
mysterious  processes  which  go  on  under  the 
influence  of  the  bacteria  in  this  underworld 
of  life,  and  to  realize  that  all  the  lore  which 
unwearied  toilers  in  the  past  have  gathered  in 
their  studies  of  the  visible  forms  of  animals 
and  plants,  makes  but  one  of  the  many  chapters 
in  nature's  stor}^-book  of  life. 

But  this  new  and  stimulating  point  of  \-iew, 
toward  which  the  studies  of  the  past  decade 
have  led  us,  does  not  look  so  largely  into  the 
domain  of  the  practical  that  it  would  greatly 
attract  the  majority  of  business  and  pleasure  and 
ennui  ridden  mankind  were  it  not  for  one  ver}- 
practical  fact  which  these  recent  studies  have  re- 
vealed. This  is,  that  among  the  myriads  of 
altogether  beneficent  bacteria  which  people  the 
earth,  and  air,  and  water,  there  are  a  few  forms 
which  have  chosen  out  of  all  the  world  as  their 
most  congenial  residence  the  bodies  of  men. 
But  even  this  would  be  of  only  passing  inter- 
est to  most  people  were  it  not  still  ftu-ther  un- 
fortimately  true  that  in  the  performance  of 
their  simple  life-processes  these  man-loving 
bacteria,  feeding  on  the  tissues  of  their  host, 
and  setting  free  certain  subtle  poisons  in  his 
66 


Tuberculosis    and    Its   Prevention 

blood,  each  after  its  kind,  can  induce  those 
disturbances  of  the  body's  functions  and  those 
changes  in  its  structure  which  we  call  disease. 

The  diseases  caused  by  the  growth  of  germs 
in  the  body  are  called  infectious.  The  germs 
causing  some  of  the  infectious  diseases  are 
given  off  from  the  bodies  of  their  victims  in 
such  form  as  to  be  readily  transmitted  through 
the  air  to  others,  in  whom  they  may  incite 
similar  disease.  Such  diseases  are  spoken  of 
as  readily  communicable,  though  it  is  not  actu- 
ally the  disease  itself,  but  only  the  germ  causing 
it,  which  is  transmitted.  In  other  infectious 
diseases  transmission  but  rarely  occurs.  Many 
infectious  diseases  are  very  easily  communi- 
cated from  the  sick  to  the  well  under  unsanitary 
and  uncleanly  conditions,  which  with  proper 
care  are  very  little  liable  to  spread. 

I  need  not  here  put  on  parade  the  whole 
uncanny  list  of  germ  diseases,  in  which  tuber- 
culosis stands  foremost,  followed  by  pneu- 
monia, diphtheria,  typhoid  fever,  scarlatina, 
cholera,  small-pox,  and  the  rest.  *Nor  need  I 
call  to  mind  the  means  by  which  our  .growing 
knowledge  in  this  domain  has  been  day  by  day 
laid  under  tribute  for  suggestions  of  hope  and 
safety  for  the  stricken.  It  is  a  record  of  brilliant 
conquest  in  nature,  and  already  of  far-reaching 
beneficence   to  man. 

But  the  great  fundamental  advance  which 
signalizes  the  past  decade  is  the  lifting  of  this 
whole  class  of  fateful  germ  diseases  out  of  the 
67 


Masterpieces   of   Science 

region  of  the  intangible  and  m3-sterious,  and 
their  estabhshment ,  on  the  basis  of  positive 
experimental  research,  in  the  domain  of  the 
comprehensible  and  definite.  The  things  which 
cause  them  are  no  longer  for  us  mysterious 
emanations  from  the  sick,  or  incorporate  ex- 
pressions of  malign  forces  against  which  con- 
jurations or  prayers  could  alone  promise  pro- 
tection, but  they  are  particulate  beings,  never 
self-engendered,  never  evolved  in  the  body, 
always  entering  from  without — things  which 
we  can   see   and  handle   and  kill. 

Let  us  now  glance  at  the  germ  called  the 
tubercle  bacillus,  the  germ  which  induces  and 
which  alone  can  induce  tuberculosis.  It  does 
not  exist  and  thrive  in  the  body  of  men  or  ani- 
mals in  health.  Without  the  entrance  of  this 
particular  germ  into  the  human  body  from  with- 
out, tuberculosis  cannot  develop  in  it.  Without 
the  transmission  of  this  germ  in  some  way  or 
other  in  a  living  condition  from  the  sick  to  the 
well,  tuberculosis  cannot  spread.  In  the  life- 
story  of  this  tiny  germ  lie  both  the  potency 
for  mischief  which  we  deplore  and  the  secret  of 
our   release   from   its   bondage. 

The  tubercle  bacillus  is  a  little  colourless, 
rod-like  plant,  so  small  that  even  many  thou- 
sands of  them  piled  together  would  make  a  heap 
far  too  small  to  be  visible  to  the  naked  eye. 
It  cannot  move  about,  nor  can  it  grow  without 
moisture,  nor  at  a  temperature  much  above 
or  much  below  that  of  the  human  body.  The 
68 


Tuberculosis    and    Its    Prevention 

material  on  which  it  feeds  must  be  very  nicely 
adapted  to  its  requirements,  and  it  has  no  lurk- 
ing and  growing  places  in  nature  outside  of 
the  bodies  of  men  and  a  few  warm-blooded 
animals.  It  can  be  cultivated  artificially  in 
the  laboratory,  and  we  know  more  about  its 
life  and  peculiarities  than  about  almost  any 
other  germ.  While  it  can  remain  alive  in  a 
dried  state  for  many  weeks,  it  is  readily  killed 
by  heat,  by  sunlight,  and  by  many  of  those 
chemical  substances  which  we  call  disinfectants. 
It  does  not  flourish  equally  well  in  the  bodies 
of  all  human  beings. 

When  once  it  gains  lodgment  in  a  body 
suited  to  its  growth  it  multiplies  slowly,  each 
germ  dividing  and  subdividing,  taking  from 
the  tissues  material  for  its  growth,  and  return- 
ing to  them  certain  subtle  poisons  which  it  sets 
free.  The  action  of  the  tubercle  bacillus  is  pecu- 
liar in  that  it  stimulates  the  cells  of  the  body, 
wherever  it  may  lodge  and  grow,  to  the  forma- 
tion of  little  masses  of  new  tissue,  which  we 
call  tubercles.  These  tubercles  are  as  a  rule 
short-lived,  and,  if  the  disease  progresses,  tend 
to  disintegrate.  If  the  tubercles  have  grown 
in  such  situations  as  to  make  this  possible,  as 
in  the  intestinal  canal  or  the  lungs,  the  dis- 
integrated and  broken-down  material,  often 
containing  myriads  of  the  living  germs,  may 
be  cast  off  from  the  body.  In  tuberculosis  of 
the  lungs,  or  consumption,  this  waste  material 
is  thrown  off  with  the  sputum  [spittle].      While 


Masterpieces   of   Science 

almost  any  part  of  the  body  may  be  affected, 
tuberculosis  of  the  lungs  is  by  far  the  most 
common  form  of  the  disease. 

It  follows  from  what  has  been  said  that  the 
only  way  in  which  we  can  acquire  tuberculosis 
is  by  getting  into  our  bodies  tubercle  bacilli 
from  tuberculous  men  or  animals.  The  only 
animals  liable  to  convey  the  disease  to  man  are 
tuberculous  cattle,  and  these  through  the  use 
of  either  meat  or  milk.  The  danger  from  the 
use  of  uncooked  meat  or  the  unboiled  milk  from 
tuberculous  cattle  is  real  and  serious,  but  it 
will  not  be  considered  here  at  length,  because 
the  great  and  prevailing  danger  of  infection 
comes    from    another   source. 

Almost  as  soon  as  the  significence  of  the 
tubercle  bacillus  was  established,  a  series  of 
studies  was  undertaken  on  the  possibility  of 
the  spread  of  the  disease  by  the  breath  or  ex- 
halations of  the  persons  of  consumptives.  These 
studies  at  once  showed  that  the  tubercle  bacillus 
cannot  be  given  off  into  the  air  of  the  breath 
from  the  moist  surfaces  of  the  mouth  and  air 
passages,  nor  from  any  material  which  may 
come  from  them  while  this  material  remains 
moist,  nor  from  healthy  unsoiled  surfaces  of 
the  body.  The  establishment  of  this  fact  is  of 
far-reaching  consequence,  because  it  shows  that 
neither  the  person  nor  the  breath  of  the  con- 
sumptive is  a  direct  source  of  danger,  even  to 
the  most  constant  and    intimate  attendants. 

A^Tiile  the  discharges  from  the  bowels  in  per- 
70 


Tuberculosis    and    Its    Prevention 

sons  suffering  from  tuberculosis  of  the  in- 
testinal tract  may  contain  many  living  bacilli, 
the  usual  mode  of  disposal  of  these  discharges 
protects  us  from  any  considerable  danger  from 
this  source. 

It  is  the  sputum  after  its  discharge  from  the 
body  on  which  our  attention  must  be  fixed. 
While  the  sputum  is  moist  it  can,  as  a  rule, 
do  no  harm,  unless  it  should  be  directly  trans- 
mitted to  those  who  are  well  by  violent  cough- 
ing, sneezing,  etc.,  by  the  use  of  uncleansed 
cooking  or  eating  utensils,  by  soiled  hands, 
or  by  such  intimate  personal  contact  as  kissing 
or  fondling.  But  if  in  any  way  the  sputum 
becomes  dried,  on  floors  or  walls  or  bedding,  on 
handkerchiefs  or  towels,  or  on  the  person  of 
the  patient,  it  may  soon  become  disseminated 
in  the  air  as  dust,  and  can  thus  be  breathed 
into  the   lungs  of  exposed  persons. 

The  wide  distribution  of  tubercle  bacilli  in 
the  air  of  living-rooms,  and  in  other  dusty 
places  where  people  go,  is  due  partly  to  the 
frequency  of  the  disease  and  the  large  numbers 
of  living  bacilli  which  are  cast  off  in  the  sputum 
(sometimes  millions  in  a  day),  and  partly  to 
the  fact  that  many  of  the  victims  of  consump- 
tion go  about  among  their  fellows  for  purposes 
of  business  or  pleasure  for  months  or  years. 
So  each  consumptive,  if  not  intelligently  careful, 
may  year  after  year  be  to  his  fellow-men  a 
source  of  active  and  serious  and  continual  in- 
fection. 

71 


Masterpieces   of   Science 

This,  then,  the  dried,  uncared-for  sputum 
of  those  suffering  from  piilmonar\-  tuberculosis, 
is  the  great  source  of  danger;  this  the  means 
so  long  concealed  by  which  a  large  part  of  the 
human  race  prematurely  perishes.  Let  but  this 
discharged  material  be  rendered  harmless  or 
destroyed  before  it  dries  in  all  cases,  and  the 
ravages  of  this  scourge  would  largely  cease. 
This  is  not  a  theoretic  matter  only,  for  again 
and  again  have  the  li^-ing  and  virulent  germs 
been  found  clinging  to  the  walls  and  furniture 
and  bedding  and  handkerchiefs  of  consump- 
tive persons,  and  in  the  dust  of  the  rooms  in 
which  they  dwell.  A  malady  whose  \4ctims  far 
outnirmber  those  of  all  other  infectious  dis- 
eases put  together,  sparing  neither  rich  nor 
poor,  seizing  upon  life  while  it  is  as  yet  only  a 
promise,  but  most  inexorable  in  the  fulness  of 
its  tide — this  malady  can  be  largely  prevented 
by  the  universal  and  persistent  practice  of 
intelligent    cleanliness. 

W'e  have  learned  in  the  past  few  years  one 
fact  about  tubercvdosis  which  is  of  incalculable 
comfort  to  many,  and  that  is  that  the  disease 
is  not  hereditary-.  It  is  ver}'  important  that 
we  should  understand  this,  because  it  seems 
to  .contradict  a  long-prevalent  tradition,  and 
a  belief  still  ^-idely  and  sorrowfully  entertained. 
Bacteria,  and  especially  most  disease-producing 
bacteria,  are  ver}^  sensitive  in  the  matter  of 
growth  and  reproduction  to  the  conditions 
under    which    they    are    placed,    and    especially 


Tuberculosis    and    Its    Prevention 

to  the  material  on  which  they  feed.  So  that  a 
germ  which  can  induce  serious  disease  in  one 
species  of  animal  is  harmless  in  the  body  of  a 
different  though  closely  allied  form.  More  than 
this,  different  individuals  of  the  same  species, 
or  the  same  individual  at  different  times,  may 
have  the  most  marked  differences  in  suscepti- 
bility in  the  presence  of  disease-producing 
germs.  What  this  subtle  difference  is  we  do 
not  know.  Whether  the  body  at  one  time  affords 
a  congenial  soil  to  the  invading  germs  and  at 
another  does  not,  whether  its  marvelous  and 
complex  powers  of  resisting  the  virulent  ten- 
dencies of  disease-producing  bacteria  at  one 
period  or  in  one  individual  are  more  vigorous 
than  in  another,  and  vary  at  different  times, 
we  do  not  certainly  know.  This,  however,  we 
do  know,  that  certain  individuals  are  more 
likely  than  others  to  yield  to  the  incursions  of 
the  tubercle  bacillus.  This  vulnerability  in 
the  presence  of  invading  germs  we  call  sus- 
ceptibility, and  susceptibility  to  the  action  of 
the  tubercle  bacillus  is  hereditary.  It  is  not 
the  disease,  tuberculosis,  which  comes  into  the 
world  with  certain  individuals  or  with  succes- 
sive children  of  the  same  family,  but  the  apti- 
tude to  contract  it  should  external  conditions 
favour.  What  subtle  impress  on  the  cells  which 
are  to  develop  into  the  new  individual  renders 
him  more  than  another  an  easy  prey  to  the 
tubercle  bacillus  should  it  later  find  lodgment 
in  his  body  we  do  not  know,  and  we  may  not 
73 


Masterpieces   of   Science 

hope  soon  to  be  enlightened,  since  all  the  in- 
tricate mysteries  of  heredity  seem  involved  in 
the  problem.  But  this  we  do  know,  that  how 
ever  much  the  child  of  tuberculous  parents  or 
a  member  of  a  tuberculous  family  may  be  pre- 
disposed to  the  disease,  he  cannot  acquire  tuber- 
culosis unless  by  some  mischance  the  fateful 
germ  enters  his  body  from  without.  What  has 
been  all  through  these  years  regarded  as  the 
strongest  proof  of  the  hereditary-  transmission 
of  tuberculosis — namely,  the  occurrence  of  the 
disease  in  several  members  of  the  same  house- 
hold— is,  in  the  new  light,  simply  the  result 
of  household  infection — the  breathing  of  air 
especially  liable  to  contain  the  noxious  germs, 
or  their  entrance  in  some  other  way  into  the 
bodies  of  persons  especially  sensitive  to  their 
presence.  I  do  not  mean  to  imply  that  tinder 
no  conditions  can  the  tubercle  bacillus  be  trans- 
mitted from  the  mother  to  the  child  before 
its  birth.  In  a  few  instances  this  is  believed 
to  have  happened.  But  its  occurrence  is  so 
extremely  infrequent  that  it  may  be  regarded 
as  accidental,  and  of  no  serious  importance 
from  otu*  present  point  of  view. 

But  it  vriW  perhaps  be  said,  "If  the  tubercle 
bacilli  are  so  'v\-idely  diffused,  why  do  we  not 
all  acquire  tuberculosis,  and  why  was  the  world 
not  long  since  depopulated?"  In  order  to  ex- 
plain this  matter  I  must  ask  the  reader  to  look 
with  me  for  a  moment  at  some  of  the  body's 
natural  safeguards  against  bacterial  and  other 
74 


Tuberculosis    and    Its    Prevention 

invaders  from  the  air.  It  has  been  found  that 
a  person  breathing  in  germ  and  dust-laden  air 
through  the  nose  breathes  out  again  air  which 
is  both  dust  and  germ  free.  The  air  passages 
of  the  nose  are  tortuous,  and  Hned  with  a  moist 
membrane,  against  which  the  air  impinges  in 
its  passage.  On  these  moist  surfaces  most  of 
the  solid  suspended  particles,  the  germs  among 
them,  are  caught  and  held  fast,  and  may  be 
thrown  off  again  by  secretion.  In  breathing 
through  the  mouth  this  safeguard  is  not  util- 
ized. Again,  the  upper  passages  leading  to 
the  lungs  are  lined  with  a  delicate  membrane 
of  cells,  whose  free  surfaces  are  thickly  beset 
with  tiny  hairlike  projections.  These  pro- 
jections are  constantly  moving  back  and  forth 
with  a  quick  sweep,  in  such  a  way  that  they 
carry  small  particles  which  may  have  escaped 
the  barriers  above  up  into  the  mouth,  from 
which  they  may  be  readily  discharged.  In  this 
way  much  of  the  evil  of  breathing  dust  and 
germ-laden  air  is  averted.  But  in  spite  of  these 
natural  safeguards  a  great  deal  of  foreign  material 
does,  under  the  ordinary  conditions  of  life  in- 
doors or  in  dusty  places,  find  lodgment  in  the 
delicate  recesses  of  the  lungs.  The  body  toler- 
ates a  good  deal  of  the  deleterious  material, 
but  its  overtasked  toleration  fails  at  last,  when 
serious   disease  may  ensue. 

When  ordinary  forms  of  living  bacteria   get 
into  the  tissues  of  the  body,   a  very   complex 
cellular  mechanism,  not  fully  understood,  usually 
75 


Masterpieces   of   Science 

results  in  their  destruction  and  ultimate  re- 
moval. In  the  presence  of  the  tubercle  bacillus 
the  body  cells  are  often  able  to  build  a  dense 
enclosing  wall  around  the  affected  region, 
shutting  it  off  from  the  rest  of  the  body.  This 
is  one  of  the  modes  of  natural  cure.  The  body 
cells  are  sometimes  able,  if  sustained  by  nour- 
ishing food  and  an  abundance  of  fresh  air,  to 
carr}'  on,  year  after  year,  a  successful  struggle 
with  the  invading  germs,  so  that  the  usefulness 
and  enjoyment  of  life  are  but  little  interfered 
with.  Finally,  a  certain  proportion  of  human 
beings  seem  to  be  endowed  at  birth  with  some 
as  yet  unknown  quality  in  the  cells  or  fluids 
of  the  body  which  naturally  unfits  them  for 
the  life  uses  of  the  tubercle  bacillus,  and  so 
renders  the  individual  for  longer  or  shorter 
periods    practically    immune. 

Others,  on  the  contrary^,  are,  as  we  have  seen, 
from  birth  unusually  susceptible.  This  inherited 
susceptibility  to  the  incursions  of  the  tubercle 
bacillus,  should  this  find  lodgment  in  the  body 
from  without,  by  no  means  always  reveals 
itself  in  any  apparent  lack  of  vigour  or  robust- 
ness of  the  body.  Still,  any  habit  or  mode  of 
life  which  diminishes  the  bodily  vigour,  whether 
in  those  predisposed  to  this  malady  or  in  the 
apparently  immune,  and  gives  it  a  leaning  to- 
ward disease,  diminishes,  as  a  rule,  the  chances 
of  a  successful  contest  with  the  bacillus.  Ana 
so  it  is  that  in  spite  of  the  wide  distribution 
of  these  fateful  germs  in  frequented  places, 
76 


Tuberculosis    and    Its    Prevention 

and  the  tendency  of  certain  vtilnerable  persons 
to  succumb  to  their  ravages,  so  many  people 
are  not  affected  by  them,  and  so  many,  al- 
though not  altogether  escaping  their  malign 
influence,  are  ^^et  able  to  wrest  at  least  a 
moiety  of  life  from  the  hand  of  the  great 
destroyer. 

The  degree  of  success  which  may  attend  our 
crusade  against  tuberculosis  will  largely  depend 
upon  the  wide  diffusion  of  the  knowledge  of 
its  communicability  by  means  of  the  sputum 
dried  and  powdered  and  floating  in  the  air  as 
dust,  and  the  intelligent  persistence  with  which 
the  morbid  material  may  be  safely  cared  for 
at  its  sources.  The  resolute  avoidance  by  con- 
sumptives of  the  not  only  filthy  but  dangerous 
practice  of  spitting  upon  floors  or  streets,  or 
anywhere  else  except  into  proper  receptacles; 
the  use  of  receptacles  which  may  be  and  are 
frequently  and  thoroughly  cleansed,  and,  best 
of  all,  of  water-proof  paper  cups,  which  with 
their  contents  may  be  burned;  or.  when  cir- 
cumstances require,  the  receiving  of  the  danger- 
ous material  on  cloths  or  Japanese  paper  nap- 
kins, which  may  be  destroyed  by  fire,  and  not 
on  more  valuable  handkerchiefs  on  which 
the  sputum  is  allowed  to  dry  while  in  use  or 
before  disinfection  and  washing;  scrupulous 
care  by  others  of  the  sputum  of  those  too  ill 
to  care  for  it  themselves — these  are  the  com- 
paratively simple  means  from  which  we  may 
most  confidently  expect  relief.  The  details  of 
77 


Masterpieces   of   Science 

these  precautions  and  their  adaptation  to  the 
special  circumstances  of  those  suffering  from 
the  disease  can  be  most  wisely  left  to  the  phy- 
sician, and  though  of  paramount  importance, 
need  not  fiuther  engage  our  attention  here. 

To  the  consumptive  himself  these  measures 
are  not  without  a  \T.tal  significance.  For  his 
chances  of  recovery  may  be  in  no  small  degree 
diminished  if  he  be  more  or  less  constantly 
liable  to  a  fresh  infection  from  material  which 
he  has  once  got  rid  of,  and  which  shoidd  have 
been    destroyed. 

The  great  volumes  of  fresh,  mo\dng  air  which 
we  encounter  out-of-doors  in  properly  cleansed 
streets  usually  so  greatly  diluts  the  dust,  of 
whatever  kind,  that  little  apprehension  need 
be  felt  from  its  presence.  When,  however,  in 
crowded  cities,  the  streets  are,  as  is  nearly  al- 
ways the  case,  save  for  a  few  favored  localities, 
filthy,  and  but  fitfully  cared  for;  when  choking 
dust  clouds  must  be  encountered  by  the  citizen 
during  the  haphazard  and  slatternly  essays  at 
cleaning  made  by  untrained  and  irresponsible 
sweepers;  we  cannot  ignore  a  danger  from  street 
dust  which  may  well  incite  grave  apprehension. 
The  citizen  can,  if  he  must,  nui  from  the  pres- 
ence of  cloud-enwrapped  machines  furiously 
whirled  along  half-sprinkled  pavements;  he  may 
avoid  a  block  on  which  the  hand-sweepers,  in 
the  absence  or  in  disregard  of  rules,  ply  their 
nefarious  brooms  over  tmwet  siu-faces,  because 
too  indolent  or  indifferent  to  sprinkle  them — 
78 


Tuberciilosis    and    Its    Prevention 

these  things  he  can  do  if  he  be  not  willing  or 
ready  to  apply  the  citizen's  remedy  for  munici- 
pal misrule. 

But  it  is  in  rooms  either  of  dwelling  or  assem- 
bling places  that  the  ill  effects  of  infectious 
dust  are  most  potent,  because  the  air  is  here 
not  so  constantly  renewed  as  it  is  out-of-doors, 
and  is  liable  to  be  breathed  over  and  over  again. 
Dust  which  gets  into  houses  does  not  readily 
leave  them,  unless  special  and  intelligent  means 
be  directed  to  its  removal.  We  do  not  usually 
realize  that,  though  the  air  itself  in  inhabited 
rooms  is  constantly  changing  more  or  less 
rapidly  by  diffusion,  by  draughts,  or  by  pur- 
posed ventilation,  fine  dust  particles  are  not 
removed  under  the  same  influences  in  propor- 
tionate degree.  They  cling  more  or  less  ten- 
aciously to  all  surfaces  on  which  they  have 
settled,  and  especially  to  fabrics,  so  that  cur- 
rents of  abundant  force  and  sufficient  distribu- 
tion to  change  the  air  may  and  usually  do 
leave  the  lodged  dust  particles  almost  entirely 
undisturbed. 

One  of  the  most  threatening  tendencies  of 
modem  times  in  matters  of  health  is  that  of 
overcrowding  in  cities,  and  the  great  element 
of  danger  from  this  overcrowding  is  not  only 
and  not  chiefly  the  insufficiency  of  air  m  living- 
rooms  and  the  lack  of  ready  means  for  its  re- 
newal, but  the  accumulation  in  this  air  of  in- 
fectious germs  floating  with  the  dust.  Abundant 
water  supply  and  good  sewerage  have  rendered 
79 


Masterpieces   of   Science 

possible  and  measurably  safe,  so  far  as  the 
ordinary  waste  of  life  is  concerned,  the  building 
of  vast  tenements  which  swarm  with  people. 
But  the  means  of  getting  pure  air,  and  especially 
of  disposing  of  infectious  material  often  floating 
in  it  when  it  is  confined,  have  not  at  all  kept 
pace  with  the  demands  of  health  and  cleanli- 
ness. 

But  when  we  return  to  larger  and  more  liber- 
ally furnished  dwellings  of  the  well-to-do  classes, 
we  are  not  reassured,  for  in  some  respects  the 
rich  are  sadly  handicapped  by  the  "tyranny 
of  things."  Of  course,  long  and  thick  piled  car- 
pets afford  persistent  lurking-places  for  infectious 
as  well  as  other  dust.  Certainly  heavy  hang- 
ings in  a  measure  hinder  the  detergent  action 
of  the  sunlight,  shut  the  used  air  in  and  the 
fresh  air  out,  and  shelter  floating  matter  which 
might  otherwise  escape.  Without  doubt,  com- 
plex upholster}^  with  roughened  fabrics  in- 
creases the  difficulties  in  the  maintenance  of 
cleanliness.  But  the  usage  of  the  householder 
in  these  matters  will,  after  all,  depend  upon 
whether  his  practical  devotion  be  most  at 
Fashion's  or  Hygeia's  shrine.  We  may  hope 
f®r  the  coming  of  a  time  when  clean,  clear, 
ariry,  simply  furnished  living-rooms  shall  replace 
the  stuffy,  fabric  strewn  apartments  in  which 
the  fashionable  citizen  so  much  delights  to- 
day. 

In  one  particular,  however,  the  devotion  to 
cleanliness  may  be  unreservedly  insistent,  and 
80 


Tuberculosis    and    Its    Prevention 

that  is  that  in  the  cleaning  of  Hving-rooms, 
whether  occupied  by  the  sick  or  the  well,  the 
distinct  and  re/:ognized  purpose  of  the  opera- 
tion shall  be  to  remove,  and  not  simply  to  stir 
up,  the  ever-gathering  dust.'  The  past  few  years, 
so  beneficently  signalized  by  the  exploitation 
of  the  new  germ  lore,  have  seen  marked  depart- 
ures from  the  traditional  sweepings  and  dust- 
ings of  a  past  era;  and  the  emancipation  of  the 
housekeeper,  and  incidentally  of  the  household, 
from  the  thrall  of  the  pestiferous  feather  duster 
seems  fairly  under  way.  Still,  some  of  the  old 
barbarous  travesties  upon  cleaning  widely  per- 
sist. The  dry  broom  still  seeks  out  in  the  deep 
recesses  of  the  carpets  not  the  coarser  particles 
of  dirt  alone,  but  the  hordes  of  living  germs 
which  were  for  the  time  safely  ensconced,  and 
among  these  such  malignant  forms  as  the 
chances  of  the  day  have  gathered.  These  all 
are  set  awhirl  in  the  air ;  some  collect  upon  salient 
points  of  the  fittings  and  furnishings;  many 
stay  with  the  operator,  to  vex  for  hours  the 
delicate  breathing  passages  or  the  deeper  re- 
cesses of  the  lungs.  Then  in  the  lull  which  fol- 
lows, gravity  reasserts  its  sway,  and  the  myriad 
particles,  both  the  living  and  the  dead,  slowly 
settle  to  the  horizontal  surfaces,  especially 
to  the  carpets.  Then  the  feather  duster  comes 
upon  the  scene,  and  another  cyclone  befalls. 
The  result  of  it  all  is  that  the  dust  has  finally 
been  forced  to  more  or  less  completely  abandon 
the  smooth  and  shining  surfaces  where  it  would 
81 


Masterpieces   of   Science 

be  %'isible,  and  is  largely  caught  in  the  surface 
roughness  of  the  carpets  or  upholstery  or  hang- 
ings, ready  at  the  Hghtcst  footfall  or  the  chariest 
touch  to  dance  into  the  air  again,  and  be  taken 
into  the  Itings  of  the  \-ictims  of  the  prevailing  de- 
lusion— the  delusion  that  the  way  to  care  for 
always  obnoxious  and  offensive  and  often 
dangerous  dust  is  not  to  get  it  out  of  the 
house,  but  to  keep  it  stirring  in  the  air  until 
at  last  it  has  settled  where  it  does  not  vex- 
the  eye. 

By  the  use  of  moist  tea  leaves  in  the  sweep- 
ing of  carpets,  by  the  use  of  soft-textiu-ed  fabrics, 
frequently  shaken  out-of-doors,  or  by  moist 
cloths  or  chamois  in  dusting,  much  useless 
dust-scattering  may  be  avoided.  But  no  matter 
what  the  means  employed,  the  final  purpose 
of  every  household  cleaning  should  be  to  get 
the  dust,  not  afloat,  but  away. 

Probably  the  most  serious  source  of  infection 
which  one  is  liable  to  encounter  in  the  usual 
ways  of  life  is  the  occupancy  at  hotels  of 
bedrooms  vacated  by  consumptives  without 
subsequent  efficient  cleansing,  and  travel  in 
sleeping  cars.  I  need  not  enter  here  into  the 
harrowing  details  of  desperate  imcleanness  which 
the  ordinary  railway  travel  brings  to  light.  It 
is  to  be  hoped  that  popular  demand  for  reform 
in  the  routine  of  hotel-keepers  and  railroad 
managers  in  the  matter  of  ordinary  sweeping 
and  dusting,  and  in  the  precautions  against 
the  spread  of  tuberculosis,  may  soon  usher  in 
82 


Tuberculosis    and    Its    Prevention 

among  them   a   day   of  reasonable   sanitary  in^ 
telligence. 

A  belief  in  the  communicability  of  tubercu- 
losis is  becoming  widely  diffused,  and  it  would 
seem  to  be  desirable,  on  the  ground  of  policy 
alone,  for  the  managers  of  summer,  and  espe- 
cially of  winter  resorts  frequented  by  consump- 
tives, to  let  it  be  known  in  no  uncertain  way 
that  their  precautions  against  the  spread  of 
infectious  diseases  are  effectually  in  line  with 
the  demands  of  modem  sanitary  science. 

The  members  of  families  bearing  a  hered- 
itary susceptibility  to  the  acquirement  of 
this  disease  should  strive  to  foster  those  con- 
ditions which  favour  a  healthy,  vigorous  life 
in  occupation,  food,  exercise  and  amusement 
and  remember  that  for  them  more  than  for 
others  it  is  important  to  avoid  such  occupa- 
tions and  places  as  favour  the  distribution,  in 
the  air  or  otherwise,  of  the  tubercle  bacillus. 

But  when  the  individual  has  done  what  he 
can  in  making  his  surroundings  clean,  and  in 
thus  limiting  the  spread  of  the  tubercle  bacillus, 
there  still  remains  work  for  municipal  and  State 
and  national  authorities  in  diffusing  the  neces- 
sary knowledge  of  the  disease  and  its  modes 
of  prevention;  in  directly  caring  for  those  un- 
able to  care  for  themselves;  in  securing  for  all 
such  freedom  from  contact  with  sources  of  the 
disease  as  the  dictates  of  science  and  humanity 
may    require. 

To    health    boards,    either   national    or   local, 
83 


Masterpieces   of   Science 

must  be  largely  entrusted  the  primar\-  protec- 
tion of  the  people  against  the  danger  from 
tuberculous    cattle. 

A  national  bureau  of  health  might  be  of  in- 
calculable ser\-ice  in  stimulating  and  harmo- 
nizing measures  for  the  suppression  of  tuber- 
culosis in  various  parts  of  the  land,  and  in 
fostering  research  in  lines  which  promise  large 
practical  return  in  the  saving  of  life. 

Tuberculosis  has  in  this  countr}^  been  offi- 
cially almost  entirely  ignored  in  those  practical 
measures  which  health  boards  universally  recog- 
nize as  efficient  in  the  suppression  of  this  class 
of  maladies.  Physicians  are  not  now  generally 
required  to  report  it  to  the  local  health  boards. 
Systematic  official  measures  of  disinfection  are 
not  widely  practised.  But  such  official  measures 
have  been  found  extremely  useful  in  the  limi- 
tation of  other  communicable  diseases.  "Uliile 
consumption  must  logically  be  classed  with 
diphtheria  and  scarlatina  and  small-pox  as  a 
communicable  germ  disease,  it  is,  in  fact,  in  the 
light  of  our  present  knowledge,  when  intelli- 
gently cared  for,  so  little  liable  to  spread  that 
it  is  properly  exempt  from  some  of  those  sum- 
mar}'-  measures  which  health  authorities  are 
justified  in  adopting  with  the  more  readily 
and  less  avoidably  communicable  maladies. 
Moreover,  consumption  is  apt  to  involve  such 
prolonged  illness,  and  so  often  permits  affected 
persons  for  months  and  years  to  go  about  their 
usual  avocations,  that  general  isolation  would 
84 


Tuberculosis    and   Its    Prevention 

be  both  impracticable  and  inhumane.  More- 
over, for  reasons  which  it  is  hoped  are  evident 
to  the  reader,  isolation  among  those  capable 
of  caring  for  themselves  is  at  present  entirely 
unnecessary. 

But  while  extreme  measures  are  not  called 
for,  local  health  boards  must  soon  act  in  the 
prevention  of  tuberculosis.  For  the  present 
the  wisest  and  most  humane  course  would 
seem  to  be  to  attempt  to  secure  the  desired 
ends  rather  by  instruction  and  counsel  and 
help  than  by  direct  and  summary  procedures. 
There  is  no  more  pitiable  spectacle  in  this  land 
to-day  than  that  of  hundreds  of  victims  of 
advanced  tuberculosis  in  every  large  town 
who  cannot  be  comfortably  or  safely  cared 
for  in  the  dwellings  of  the  poor,  and  yet  who 
are  always  unwelcome  applicants  at  most 
of  our  hospitals  and  at  many  are  denied  admis- 
sion altogether.  They  are  victims  of  ignorance 
and  of  vicious  social  and  hygienic  conditions 
for  which  they  are  not  largely  responsible, 
and  States  and  municipalities,  which  are  most 
to  blame,  owe  them  at  least  a  shelter  and  a 
place  to  die.  Unquestionably  one  of  the  urgent 
duties  immediately  before  us  in  all  parts  of 
the  land  where  tuberculosis  prevails  is  the 
establishment  of  special  hospitals  in  which  this 
disease  can  be  treated  and  its  victims  safely 
cared    for. 

And  now  at  last  remains  to  be  spoken  what 
word  of  cheer  and  hope  our  new  outlooks  may 
85 


Masterpieces   of   Science 

have  given  us  for  those  who  are  already  under 
the  shadow  of  this  sorrowful  affliction.  The 
dreams  and  aspirations  and  strenuous  labours 
of  the  students  of  this  disease  have  looked 
steadily  toward  the  discover}-  of  some  definite 
and  positive  means  of  cure,  but  as  yet  full 
success  lingers  beyond  their  grasp.  The  methods 
for  the  early  detection  of  tuberculosis  which 
science  has  pointed  out  make  it  possible  for 
affected  persons  to  plan  such  modes  of  life  and 
early  seek  such  salubrious  climates  as  prom- 
ise a  hope  of  recover}-.  We  have  studii  d  closely 
the  v.-ays  in  which  the  cells  of  the  body  often 
successfully  resist  the  incursions  of  the  already 
seated  germs,  and  learned  how  in  many  ways 
the  natural  forces  of  cure  may  be  sustained 
and  strengthened.  We  have  learned  much  about 
certain  complicating  occurrences  which  often 
form  the  most  serious  feattires  in  the  progress 
of  tuberculosis  of  the  limgs,  and  how  they  may 
be  best  avoided.  And  so  to-da\^  the  outlook 
for  those  in  the  earlier  stages  of  this  disease 
is  in  a  considerable  proportion  of  cases  ex- 
tremely encouraging.  It  is  no  longer  for  us 
the  hopeless  malady  which  it  was  earlier  be- 
lieved to  be.  It  is  not  necessarily  a  bitter 
losing  fight  upon  which  one  enters  who  becomes 
aware  that  the  finger  of  this  disease  is  upon 
him.  A  long  and  happy  and  useful  life  may 
still  be  his  if  the  conditions  which  favour  his 
cure  be  early  and  intelligently  fixed  upon, 
and  patiently  and  faithfully  persisted  in.  The 
86 


Tuberculosis    and    Its    Prevention 

wise  physician  is  here  the  best  apviser  in  cli- 
mate and  regimen,  as  well  as  in  the  proper 
selection  of  remedial  measures,  and  the  earlier 
his  counsel  is  sought  and  acted  on,  the  brighter 
will  usually  be  the  outlook  for  recovery. 

Research  in  tuberculosis  and  the  ministra- 
tion of  the  physician  should,  and  generally 
do,  go  hand  in  hand,  and  no  time  should  be 
lost  in  bringing  to  the  aid  of  the  stricken  what 
light  and  promise  the  studies  of  the  laboratory 
day  by  day  may  yield.  The  great  and  benefi- 
cent work  which  has  been  accomplished  by 
Trudeau  in  the  Adirondack  woods,  in  at  once 
widening  the  bounds  of  knowledge  of  tuber- 
culosis and  in  carrying  to  a  successful  issue 
in  so  many  the  varied  and  delicate  processes 
of  cure,  is  a  cheering  example  of  what  may  be 
accomplished  with  persistent  devotion,  by  the 
light  of  our  new  knowledge,  in  mastering  a 
malady   so   long  considered   hopeless. 


87 


MALARIA  AND  MOSQUITOES 
George  M.  Sternberg,  M.  D.,  LL.  D. 

[Dr.  Sternberg,  Surgeon-General  of  the  United  States 
Army,  is  an  investigator  and  author  of  distinction.  His 
works  include  a  "  Manual  of  Bacteriology,"  a  "  Text-Book  of 
Bacteriology,"  and  "Immunity,  Protective  Inoculations 
and  Serum-Therapy,"  all  published  by  William  Wood  &  Co., 
New  York.  The  address  which  follows  was  delivered  by 
Dr.  Sternberg  as  president  of  the  Philosophical  Society  of 
Washington,  December  8,  1900.  It  appeared  in  the  Popular 
Science  Monthly,  February,  1901,  copyright,  and  is  here 
reprinted  by  the  kind  permission  of  the  editor  of  the  Monthly 
and  the  author. 

A  book  well  worth  reading  in  this  connection  is  "Mos- 
quitoes," by  Leland  O.  Howard,  Chief  of  the  Division  of 
Entomology,  United  States  Department  of  Agriculture, 
Washington,  D.  C,  and  published  by  McClure,  Phillips  & 
Co.,  New  York.Q 

In  my  address  as  President  of  the  Biological 
Society,  in  1896,  the  subject  chosen  was  "The 
Malarial  Parasite  and  Other  Pathogenic  Proto- 
zoa." This  address  was  published  in  March, 
1897,  in  the  Popular  Science  Alonthly,  and  I 
must  refer  you  to  this  illustrated  paper  for  a 
detailed  account  of  the  morphological  character 
of  the  malarial  parasite.  It  is  my  intention 
at  the  present  time  to  speak  of  "Malaria"  in  a 
more  general  way,  and  of  the  recent  experi- 
mental evidence  in  support  of  Manson's  sugges- 
tion, first  made  in  1894,  that  the  mosquito  serves 
89 


Masterpieces   of   Science 

as  an  Intermediate  host  for  the  parasite.  The 
discover}'  of  this  parasite  may  justly  be  con- 
sidered one  of  the  greatest  achievements  of 
scientific  research  during  the  nineteenth  cen- 
tur\'.  Twenty-five  years  ago  the  best  informed 
physicians  entertained  erroneous  ideas  with  ref- 
erence to  the  nature  of  malaria  and  the  etiology 
[inquiry'  into  the  causes]  of  the  malarial  fevers. 
Obser^-ation  has  taught  them  that  there  was 
something  in  the  air  in  the  \-icinity  of  marshes 
in.  tropical  regions,  and  during  the  summer  and 
autumn  in  semi-tropical  and  temperate  regions, 
which  gave  rise  to  periodic  fevers  in  those  ex- 
posed in  such  localities,  and  the  usual  inference 
was  that  this  something  was  of  gaseous  form — • 
that  it  was  a  special  kind  of  bad  air  generated 
in  swampy  localities  under  favourable  meteoro- 
logical conditions.  It  was  recognized  at  the 
same  time  that  there  are  other  kinds  of  bad  air, 
such  as  the  offensive  emanations  from  sewers  and 
the  products  of  respiration  of  man  and  animals, 
but  the  term  malaria  was  reserved  especially  for 
the  kind  of  bad  air  which  was  supposed  to  give 
rise  to  the  so-called  malarial  fevers.  In  the^  light 
of  our  present  knowledge  it  is  e\'ident  that  this 
term  is  a  misnomer.  There  is  no  good  reason 
for  belie\4ng  that  the  air  of  swamps  is  any  more 
deleterious  to  those  who  breathe  it  than  the  air 
of  the  sea  coast  or  that  in  the  \-icinity  of  inland 
lakes  and  ponds.  Moreover,  the  stagnant  pools, 
which  are  covered  with  a  "'green  sctun"  and  from 
which  bubbles  of  gas  are  given  oft",  have  lost  all 
90 


Malaria    and    Mosquitoes 

terrors  for  the  well-informed  man,  except  in  so 
far  as  they  serve  as  breeding  places  for  mosquitoes 
of  the  genus  Anopheles.  The  green  scum  is 
made  up  of  harmless  algae  such  as  Spirogyra, 
Zygnema  Protococcus,  Euglena,  etc.;  and  the 
gas  which  is  given  off  from  the  mud  at  the  bot- 
tom of  such  stagnant  pools  is  for  the  most  part 
a  well-known  and  comparatively  harmless  com- 
pound of  hydrogen  and  carbon — methane  or 
* 'marsh  gas."  In  short,  w^e  now  know  that  the 
air  in  the  vicinity  of  marshes  is  not  deleterious 
because  of  any  special  kind  cf  bad  air  present 
in  such  localities,  but  because  it  contains  mos- 
quitoes infected  with  a  parasite  known  to  be  the 
specific  cause  of  the  so-called  malarial  fevers. 
This  parasite  was  discovered  in  the  blood  of 
patients  suffering  from  intermittent  fevers  by 
Laveran,  a  surgeon  in  the  French  arm^^  whose 
investigations  were  conducted  in  Algiers.  This 
famous  discovery  was  made  toward  the  end 
of  the  year  1880,  but  it  was  several  years  later 
before  the  profession  generally  began  to  attach 
much  importance  to  the  alleged  discover3^  It 
was  first  confirmed  by  Richard  in  1882;  then 
by  the  Italian  investigators,  Marchiafava,  Celli, 
Golgi  and  Bignami;  by  Councilman,  Osier  and 
Thayer  in  this  country,  and  by  many  other  com- 
petent observers  in  various  parts  of  the  world. 
The  Italian  investigators  named  not  onl}^  con- 
firmed the  presence  of  the  parasite  discovered 
by  Laveran  in  the  blood  of  those  suffering  from 
malarial  fevers,  but  they  demonstrated  its 
91 


Masterpieces   of   Science 

etiological  role  by  inociilation  experiments  and 
added  greatly  to  our  knowledge  of  its  life  history 
(1883-189S).  The  fact  that  the  life  histor>-  of 
the  parasite  includes  a  period  of  existence  in  the 
body  of  the  mosquito,  as  an  intermediate  host, 
has  recently  been  demonstrated  by  the  English 
army  surgeons  Manson  and  Ross,  and  con- 
firmed by  nimierous  obser\'ers,  including  the 
famous  German  bacteriologist,  Koch. 

The  discoveries  referred  to,  as  is  usual,  have 
had  to  withstand  the  criticism  of  conserv-ative 
physicians,  who,  ha\-ing  adopted  the  prevailing 
theories  with  reference  to  the  etiology  of  peri- 
odic fevers,  were  naturally  skeptical  as  to  the 
reliability  of  the  obser\-ations  made  by  Laveran 
and  those  who  claimed  to  have  confirmed  his 
discover}-.  The  first  contention  was  that  the 
bodies  described  as  present  in  the  blood  were  not 
parasites,  but  deformed  blood  corpuscles.  This 
objection  was  soon  set  at  rest  by  the  demonstra- 
tion, repeatedly  made,  that  the  intra-corpuscular 
forms  tmderwent  distinct  amoeboid  mo\-ements 
[resembling  those  of  the  amoeba,  a  jelly-like  organ- 
ism of  simple  type].  Xo  one  witnessing  these 
movements  could  doubt  that  he  was  obser\-ing  a 
li\-ing  micro-organism.  The  same  was  true  of 
the  extra-corpuscular  flagellate  bodies  [resem- 
bling a  whip-lash],  which  may  be  seen  to  undergo 
ver\'-  active  movements,  as  a  result  of  which 
the  red  blood  corpuscles  are  violently  displaced 
and  the  flagellate  body  itself  dashes  about  in  the 
field  of  view. 

92 


Malaria    and    Mosquitoes 

The  first  confirmation  in  this  country  of 
Laveran's  discovery  of  amoeboid  parasites  in  the 
blood  of  malarial  fever  patients  was  made  by 
myself  in  the  pathological  laboratory  of  the 
Johns  Hopkins  University  in  March,  1886.  In 
May,  1885,  I  had  visited  Rome  as  a  delegate 
to  the  International  Sanitary  Conference,  con- 
vened in  that  city  under  the  auspices  of  the 
Italian  Government,  and  while  there  I  visited 
the  Santo  Spirito  Hospital  for  the  purpose  of 
witnessing  a  demonstration,  by  Drs.  Marchia- 
fava  and  Celli,  of  that  city,  of  the  presence  of 
the  Plasmodium  malaricB  in  the  blood  of  persons 
suffering  from  intermittent  fever.  Blood  was 
drawn  from  the  finger  during  the  febrile  [feverish] 
attack  and  from  individuals  to  whom  quinine 
had  not  been  administered.  The  demonstration 
was  entirely  satisfactory,  and  no  doubt  was  left 
in  my  mind  that  I  saw  living  parasitic  micro- 
organisms in  the  interior  of  red  blood  corpuscles 
obtained  from  the  circulation  of  malarial  fever 
patients.  The  motions  were  quite  slow,  and 
were  manifested  by  a  gradual  change  of  outline 
rather  than  by  visible  movement.  After  a 
period  of  amoeboid  activity  of  greater  or  less 
duration,  the  body  again  assumed  an  oval  or 
spherical  form  and  remained  queiscent  for  a 
time.  While  in  this  form  it  was  easily  recognized, 
as  the  spherical  shape  caused  tne  light  passing 
through  it  to  be  refracted  and  gave  the  im- 
pression of  a  body  having  a  dark  contour  and  a 
central  vacuole  [minute  cavity] ;  but  when  it  was 
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Masterpieces   of   Science 

flattened  out  and  undergoing  amoeboid  changes 
in  form,  it  was  necessary  to  focus  very  carefully 
and  to  have  a  good  illumination  in  order  to  see 
it.  The  objective  used  was  a  Zeiss's  one-twelfth 
inch  homogeneous  oil  immersion. 

But,  very  properly,  skepticism  with  reference 
to  the  causal  relation  of  these  bodies  to  the 
disease  with  which  they  are  associated  was  not 
removed  by  the  demonstration  that  they  are  in 
fact  blood  parasites,  that  they  are  present  in 
considerable  numbers  during  the  febrile  parox- 
ysms. These  facts,  however,  give  strong  sup- 
port to  the  inference  that  they  are  indeed  the 
cause  of  the  disease.  This  inference  is  further 
supported  by  the  evident  destruction  of  red 
blood  corpuscles  by  the  parasite,  as  shown  by 
the  presence  of  grains  of  black  pigment  in  the 
amoeba-like  micro-organisms  observed  in  these 
corpuscles  and  the  accumulation  of  this  insoluble 
blood  pigment  in  the  liver  and  spleen  of  those 
who  have  suffered  repeated  attacks  of  inter- 
mittent fever.  The  enormous  loss  of  red  blood 
corpuscles  as  a  result  of  such  attacks  is  shown 
by  the  anaemic  condition  of  the  patient  and  also 
by  actual  enumeration.  According  to  Kelsch, 
a  patient  of  vigorous  constitution  in  the  first 
four  days  of  a  quotidian  [daily  recurrent]  inter- 
mittent fever,  or  a  remittent  of  first  invasion,  may 
suffer  a  loss  of  2,000,000  red  blood  corpuscles 
per  cubic  millimeter  of  blood,  and  in  certain  cases 
a  loss  of  1,000,000  has  been  verified  at  the  end  of 
twenty-fo\ir  hours.  In  cases  of  intermittent 
94 


Malaria    and    Mosquitoes 

fever  having  a  duration  of  twenty  to  thirty 
days  the  number  of  red  blood  cells  may  be  re- 
duced from  the  normal,  which  is  about  5,000,000 
per  cubic  millimeter,  to  1,000,000  or  even  less. 
In  view  of  this  destruction  of  the  red  blood  cells 
and  the  demonstrated  fact  that  a  certain  num- 
ber, at  least,  are  destroyed  during  the  febrile 
paroxysms  by  a  blood  parasite,  which  invades 
the  cells  and  grows  at  the  expense  of  the  con- 
tinued haemoglobin  [the  red  substance  in  the 
blood],  it  may  be  thought  that  the  etiological 
role  of  the  parasite  should  be  conceded.  But 
scientific  conser\^atism  demands  more  than  this, 
and  the  final  proof  has  been  afforded  by  the  ex- 
periments of  Gerhardt  and  of  Marchiafava  and 
Celli — since  confirmed  by  many  others.  This 
proof  consists  in  the  experimental  inoculation 
of  healthy  individuals  with  blood  containing  the 
parasite  and  the  development  of  a  typical  at- 
tack of  periodic  fever  as  a  result  of  such  inocu- 
lation. Marchiafava  and  Bignami,  in  their 
elaborate  article  upon  "Malaria,"  published  in 
the  Twentieth  Century  Practice  of  Medicine,  say: 
"The  transmission  of  the  disease  occurs  equally 
whether  the  blood  is  taken  during  the  apyretic 
[aguish]  period  or  during  a  febrile  [feverish]  par- 
oxysm, whether  it  contains  young  parasites  or 
those  in  process  of  development,  or  whether  it 
contains  sporulation  [minute  spore-like]  forms. 
Only  the  crescent  forms,  when  injected  alone, 
do  not  transmit  the  infection,  as  has  been  demon- 
strated by  Bastianelli,  Bignami  and  Thayer, 
95 


Masterpieces   of   Science 

and  as  can  be  readily  understood  when  we  re- 
member the  biological  significance  of  these  forms. 

"In  order  that  the  disease  be  reproduced  in 
the  inoculated  subject  it  is  not  necessary  to  in- 
ject the  malarial  blood  into  a  vein  of  the  recipient, 
as  has  been  done  in  most  of  the  experiments;  a 
subcutaneous  injection  is  all-sufficient.  Nor  is 
it  necessar}^  to  inject  several  cubic  centimeters, 
as  was  done  especially  in  the  earlier  experiments; 
a  fraction  of  a  cubic  centimeter  will  suffice,  and 
even  less  than  one  drop,  as  Bignami  has  shown." 

After  the  inoculation  of  a  healthy  individual 
with  blood  containing  the  parasite  a  period 
var}'ing  from  four  to  twenty-one  days  elapses 
before  the  occurrence  of  a  febrile  paroxysm. 
This  is  the  so-called  period  of  incubation,  during 
which,  no  doubt,  the  parasite  is  undergoing 
mt'.ltiplication  in  the  blood  of  the  inoculated 
indi\-idual.  The  duration  of  this  period  depends 
to  some  extent  upon  the  quantity  of  blood  used 
for  the  inoculation  and  its  richness  in  parasites. 
It  also  depends  upon  the  particular  variety  of  the 
parasite  present,  for  it  has  been  ascertained  that 
there  are  at  least  three  distinct  varieties  of  the 
malarial  parasite — one  which  produces  the 
quartan  type  of  fever,  in  which  there  is  a  paroxysm 
every  third  day  and  in  which,  in  experimental 
inoculations  made,  the  period  of  incubation  has 
varied  from  eleven  to  eighteen  da^^s;  in  the 
tertian  type,  or  second  day  fever,  the  period  of 
incubation  noted  has  been  from, nine  to  twelve 
days;  and  in  the  aestivo-autumnal  type  the  dura- 
96 


Malaria    and    Mosquitoes 

tion  has  usually  not  exceeded  five  days.  The 
parasite  associated  with  each  of  these  types  of 
fever  may  be  recognized  by  an  expert,  and  there 
is  no  longer  any  doubt  that  the  difference  in 
type  is  due  to  the  fact  that  different  varieties 
or  "species"  of  the  malarial  parasite  exist,  each 
having  a  different  period  of  development.  Blood 
drawn  during  a  febrile  paroxysm  shows  the 
parasite  in  its  different  stages  of  intra-corpuscu- 
lar  development.  The  final  result  of  this  de- 
velopment is  a  segmenting  body,  having  pig- 
ment granules  at  its  center,  which  occupies  the 
greater  part  of  the  interior  of  the  red  corpuscle. 
The  number  of  segments  into  which  this  body 
divides  differs  in  the  different  t^-pes  of  fever,  and 
there  are  other  points  of  difference  by  which  the 
several  varieties  may  be  distinguished  one  from 
the  other,  but  which  it  is  not  necessary  to  men- 
tion at  the  present  time.  The  important  point 
is  that  the  result  of  the  segmentation  of  the 
adult  parasites  contained  in  the  red  corpuscles 
is  the  formation  of  a  large  number  of  spore-like 
bodies,  which  are  set  free  by  the  disintegration 
of  the  remains  of  the  blood  corpuscles  and  which 
constitute  a  new  brood  of  reproductive  elements, 
which  in  their  turn  invade  healthy  blood  cor- 
puscles and  effect  their  destruction.  This  cycle 
of  development  without  doubt  accounts  for  the 
periodicity  of  the  characteristic  febrile  parox- 
ysms; and,  as  stated,  the  different  varieties  com- 
plete their  cycle  of  development  in  different 
period  of  time,  thus  accounting  for  the  recur- 
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Masterpieces   of   Science 

rence  of  the  paroxysms  at  intervals  of  forty- 
eight  hours,  in  one  type  of  fever,  and  of  three 
days  in  another  type.  When  a  daily  paroxysm 
occurs,  this  is  believed  to  be  due  to  the  alternate 
development  of  two  groups  of  parasites  of  the 
tertian  variety,  as  it  has  not  been  possible  to 
distinguish  the  parasite  found  in  the  blood  of 
persons  suffering  from  a  quotidian  form  of  inter- 
mittent fever  from  that  of  the  tertian  form. 
A'er}^  often,  also,  the  daily  paroxysm  occurs  on 
succeeding  days  at  a  different  hour,  while  the 
paroxysm  evers^  alternate  day  at  the  same 
hour  is  a  fact  which  sustains  the  \'iew  that  we 
have  to  deal,  in  such  cases,  with  two  broods  of 
the  tertian  parasite  which  mature  on  alternate 
days.  In  other  cases  there  may  be  two  dis- 
tinct paroxysms  on  the  same  day,  and  none  on 
the  following  day,  indicating  the  presence  of 
two  broods  of  tertian  parasites  maturing  at 
different  hours  ever\^  second  day. 

The  hypothesis  that  malarial  infection  results 
from  the  bites  of  mosquitoes  was  advanced  and 
ably  supported  by  Dr.  A.  F.  A.  King,  of  Wash- 
ington, D.  C,  in  a  paper  read  before  the  Philo- 
sophical Society  on  Februar}^  lo,  1883,  and  pub- 
lished in  the  Popular  Scieyice  Monthly  in  Septem- 
ber of  the  same  year.  In  1S94,  Manson  supported 
the  same  hypothesis  in  a  paper  published  in  the 
British  Medical  Journal  (December  8),  and  the 
following  year  (1895)  Ross  made  the  important 
discovery  that  when  blood  containing  the  cres- 
centic    bodies   was   ingested    by   the   mosquito, 


Malaria    and    Mosquitoes 

these  crescents  rapidly  underwent  changes  similar 
to  those  heretofore  described,  resulting  in  the 
formation  of  motile  [spontaneously  moving]  fila- 
ments, which  become  detached  from  the  parent 
body  and  continue  to  exhibit  active  movements. 
In  1897,  Ross  ascertained,  further,  that  when 
blood  containing  crescents  was  fed  to  a  particu- 
lar species  of  mosquito,  living  pigmented  para- 
sites could  be  found  in  the  stomach  walls  of 
the  insect.  Continuing  his  researches  with  a 
parasite  of  the  same  class  which  is  found  in  birds, 
and  in  which  the  mosquito  also  serves  as  an  inter- 
mediate host,  Ross  found  that  this  parasite 
enters  the  stomach  wall  of  the  insect,  and,  as  a 
result  of  its  development  in  that  locality,  forms 
reproductive  bodies  (sporozoites) ,  which  subse- 
quently find  their  way  to  the  veneno-salivary 
[poisonous  salivary]  glands  of  the  insect  which 
is  now  capable  of  infecting  other  birds  of  the  same 
species  as  that  from  which  the  blood  was  ob- 
tained in  the  first  instance.  Ross  further 
showed  that  the  mosquito  which  served  as  an 
intermediate  host  for  this  parasite  could  not 
transmit  the  malarial  parasite  of  man  or  another 
similar  parasite  of  birds  (halteridium) .  These 
discoveries  of  Ross  have  been  confirmed  by 
Grassi,  Koch  and  others,  and  it  has  been  shown 
that  the  mosquitoes  which  serve  as  intermediate 
host  for  the  malarial  parasites  of  man  belong 
to  the  genus  Anopheles,  and  especially  to  the 
species  known  as  Anopheles  claviger. 

The    question    whether    mosquitoes    infected 
99 


Masterpieces   of   Science 

with  the  malarial  parasite  invariably  become 
infected  as  a  result  of  the  ingestion  [taking  in] 
of  human  blood  containing  this  parasite  has 
not  been  settled  in  a  definite  manner,  but  cer- 
tain facts  indicate  that  this  is  not  the  case.  Thus 
there  are  localities  noted  for  being  extremely- 
dangerous  on  account  of  the  malarial  fevers 
contracted  by  those  who  visit  them,  which  on 
this  very  account  are  rarely  visited  by  man. 
Yet  there  must  be  a  great  abundance  of  infected 
mosquitoes  in  these  localities,  and  especially 
in  low  swampy  regions  in  the  tropics.  If  man 
and  the  mosquitoes  are  alone  concerned  in  the 
propagation  of  this'  parasite,  how  shall  we  ac- 
count for  the  abundance  of  infected  mosquitoes 
in  uninhabited  marshes?  It  appears  probable 
that  some  other  vertebrate  animal  serves  in  place 
of  man  to  maintain  the  life  cycle  of  the  parasite, 
or  that  it  may  be  propagated  through  successive 
generations  of  mosquitoes. 

It  is  well  known  that  persons  engaged  in  dig- 
ging canals,  railroad  cuts,  etc.,  in  malarious 
regions  are  especially  liable  to  be  attacked  with 
one  or  the  other  of  the  forms  of  malarial  fever. 
This  may  be  due  to  the  fact  that  the  digging 
operations  result  in  the  formation  of  little  pools 
suitable  for  the  development  of  the  eggs  of  Ano- 
pheles, but  another  explanation  has  been  offered. 
Ross  and  others  have  found  in  infected  mosqui- 
toes certain  bodies,  described  by  Ross  as  "  black 
spores,"  which  resist  decomposition  and  which 
may  be  resting  spores  capable  of  retaining  their 
100 


Malaria    and    Mosquitoes 

vitality  for  a  long  time.  The  suggestion  is  that 
these  "  black  spores  "  or  other  incysted  [enclosed 
in  a  small  vessel]  reproductive  bodies  may  have 
been  deposited  in  the  soil  by  mosquitoes  long 
since  defunct,  "and  that  in  moving  the  soil  these 
dormant  parasites  are  set  at  liberty,  and  so,  in 
air,  in  water  or  otherwise,  gain  access  to  the 
workmen  engaged"  (Manson).  This  hypothesis 
is  not  supported  by  recent  observations,  which 
indicate  that  infection  in  man  occurs  only  as  a 
result  of  inoculation  through  the  bite  of  an  in- 
fected mosquito.  The  question  is  whether 
malarial  fevers  can  be  contracted  in  marshy 
localities  independently  of  the  mosquito,  which 
has  been  demonstrated  to  be  an  intermediate 
host  of  the  malarial  parasite  ?  Is  this  parasite 
present  in  the  air  or  water  in  such  localities  as 
well  as  in  the  bodies  of  infected  mosquitoes  ?  Its 
presence  has  never  been  demonstrated  by  the  mi- 
croscope; but  this  fact  has  little  value  in  view  of 
the  great  variety  of  micro-organisms  present  in 
marsh  water  or  suspended  in  the  air  everywhere 
near  the  surface  of  the  ground,  and  the  difficulty 
of  recognizing  the  elementary  reproductive 
bodies  by  which  the  various  species  are  main- 
tained through  successive  generations.  It  would 
appear  that  a  crucial  experiment  for  the  determi- 
nation of  this  question  would  be  to  expose 
healthy  individuals  in  a  malarious  region  and 
to  exclude  the  mosquito  by  some  appropriate 
means.  This  experiment  has  been  made  during 
the  past  summer,  and  the  "'^sult  up  to  the  present 
101 


Masterpieces   of   Science 

time  has  been  reported  by  Manson  in  the  Lon- 
don Lancet  of  September  29,  1900.  Five  healthy 
individuals  have  lived  in  a  hut  on  the  Roman 
Campagna  since  early  in  the  month  of  July. 
They  have  been  protected  against  mosquito 
bites  by  mosquito-netting  screens  in  the  doors 
and  windows  and  b}-  mosquito  bars  over  the 
beds.  They  go  about  freely  during  the  day- 
time but  remain  in  their  protected  hut  from 
sunset  to  sunrise.  At  the  time  Manson  made 
his  report  all  these  individuals  remained  in  per- 
fect health.  It  has  long  been  known  that  labour- 
ers could  come  from  the  \-illages  in  the  moun- 
tainous region  near  the  Roman  Campagna  and 
work  during  the  day,  returning  to  their  homes 
at  night,  without  great  danger  of  contracting 
the  fever,  while  those  who  remained  on  the 
Campagna  at  night  ran  great  risk  of  falling  sick 
with  fever,  as  a  result  of  "exposure  to  the  night 
air."  What  has  already  been  said  makes  it  ap- 
pear extremely  probable  that  the  "night  air," 
by  itself,  is  no  more  dangerous  than  the  day  air, 
but  that  the  real  danger  consists  in  the  presence 
of  infected  mosquitoes  of  a  species  which  seeks 
its  food  at  night.  As  pointed  out  by  King, 
in  his  paper  already  referred  to,  it  has  repeatedly 
been  claimed  by  travelers  in  malarious  regions 
that  sleeping  under  a  mosquito  bar  is  an  effectual 
method  of  prophylaxis  [prevention]  against  inter- 
mittent fevers. 

That  malarial  fevers  may  be  transmitted  by 
mosquitoes    of   the    genus    Anopheles   was    first 
'i02 


Malaria   and   Mosquitoes 

demonstrated  by  the  Italian  physician  Bignanii, 
whose  experiments  were  made  m  the  Santo 
Spirit©  Hospital  in  Rome.  The  subjects  of  the 
experiment,  with  their  full  consent,  were  placed 
in  a  suitable  room  and  exposed  to  the  b^'tes  of 
mosquitoes  brought  from  Maccarese,  "a  marshy 
place  with  an  evil  but  deserved  reputation  for 
the  intensity  of  its  fevers."  It  has  been  objected 
to  these  experiments  that  they  were  made  in 
Rome,  at  a  season  of  the  year  when  malarial 
fevers  prevail  to  a  greater  or  less  extent  in  that 
city,  but  Marchifava  and  Bignami  say: 

"It  is  well  known  to  all  physicians  here  that, 
although  there  are  some  centers  of  malaria  in 
certain  portions  of  the  suburbs,  the  city  proper 
is  entirely  free  from  malaria,  as  long  experience 
has  demonstrated,  and  at  no  season  of  the  year 
does  one  acquire  the  disease  in  Rome." 

In  view  of  the  objection  made,  a  crucial  ex- 
periment has  recently  been  made  in  the  city  of 
London.  The  result  is  reported  by  Manson, 
as  follows: 

"Mosquitoes  infected  with  the  parasite  of 
benign  tertian  malarial  fever  were  sent  from 
Rome  to  England,  and  were  allowed  to  feed 
upon  the  blood  of  a  perfectly  healthy  individual 
(Dr.  Hanson's  son,  who  had  never  had  malarial 
disease).  Forty  mosquitoes,  in  all,  were  al- 
lowed to  bite  him  between  August  29  and  Sep- 
tember 12.  On  September  14  he  had  a  rise  of 
temperature,  with  headache  and  slight  chilliness, 
but  no  organisms  were  found  in  his  blood.  A 
103 


Masterpieces    of   Science 

febrile  paroxysm  occurred  daily  thereafter,  but 
the  parasites  did  not  appear  in  the  blood  until 
September  17,  when  large  numbers  of  typical 
tertian  parasites  were  found.  They  soon  dis- 
appeared under  the  influence  of  quinine." 

We  have  still  to  consider  the  question  of  the 
transmission  of  malarial  fevers  by  the  ingestion 
of  water  from  malarious  localities.  Numerous 
medical  authors  have  recorded  facts  which  they 
deemed  convincing  as  showing  that  malarial 
fevers  may  be  contracted  in  this  way.  I  have 
long  been  of  the  opinion  that  while  the  o|^ser\ed 
facts  may,  for  the  most  part,  be  authentic,  the 
inference  is  based  upon  a  mistake  in  diagnosis 
[determination].  That,  in  truth,  the  fevers  which 
can  justly  be  ascribed  to  the  ingestion  [taking 
into  the  bod}-]  of  a  contaminated  water  supply 
are  not  true  malarial  fevers — /.  e.,  they  are  not 
due  to  the  presence  of  the  malarial  parasite  in 
the  blood.  This  ^-iew  was  sustained  by  me, 
in  my  work  on  'Malaria  and  Malarial  Diseases," 
published  in  1883.  The  fevers  supposed  to 
have  been  contracted  in  this  way  are,  as  a  rule, 
continued  or  remittent  in  character,  and  they 
are  known  under  a  variety  of  names.  Thus  we 
have  "Roman  fever,"  "Naples  fever."  "remit- 
tent fever,"  "mountain  fever,"  "t\-pho-malarial 
fever."  etc.  The  leading  physicians  and  path- 
ologists, in  regions  where  these  fevers  prevail,  are 
now  con\4nced  that  they  are  not  malarial  fevers, 
but  are  simply  more  or  less  typical  varieties  of 
typhoid  fever,  a  disease  due  to  a  specific  bacil- 
104 


Malaria    and   Mosquitoes 

lus  [minute  comma-shaped  plant],  and  which  is 
commonly  contracted  as  a  result  of  the  ingestion 
of  contaminated  water  or  food.  The  error  in 
diagnosis,  upon  which  the  inference  has  been 
based  that  malarial  fevers  may  be  contracted 
through  drinking  water,  has  been  widespread 
in  this  country,  in  Europe  and  in  the  British  pos- 
sessions in  India.  It  vitiated  our  medical  sta- 
tistics of  the  Civil  War  and  of  the  recent  war 
with  Spain.  In  my  work  already  referred  to, 
I  say: 

"Probably  one  of  the  most  common  mistakes 
in  diagnosis,  made  in  all  parts  of  the  world  where 
malarial  and  enteric  [intestinal]  fevers  are  en- 
demic [characteristic  of  the  locality],  is  that  of 
callihg  an  attack  of  fever,  belonging  to  the  last 
mentioned  category,  malarial  remittent.  This 
arises  from  the  difficulties  attending  a  differential 
diagnosis  at  the  outset,  and  from  the  fact  that 
having  once  made  a  diagnosis  of  malarial  fever, 
the  physician,  even  if  convinced  later  that  a 
mistake  has  been  made,  does  not  always  feel 
willing  to  confess  it.  The  case  therefore  appears 
in  the  mortality  returns,  if  it  prove  fatal,  or  in 
the  statistical  reports  of  disease,  if  made  by 
an  army  or  navy  surgeon,  as  at  first  diagnosed." 


105 


THE   ART    OF    PROLONGING   LIFE 

ROBSON  ROOSE,  M.  D. 

[Dr.  Robson  Roose,  an  eminent  physician  of  London,  is 
the  author  of  standard  works  on  Gout  on  Nerve  Prostration, 
on  Waste  and  Repair  in  Modem  Life.  The  Fortnightly 
Review,  1889,  contained  the  admirable  article  which  follows: 
it  is  reprinted  with  the  kind  permission  of  the  author  and 
the  editor.Q 

The  doctrine  that  a  short  life  is  a  sign  of 
divine  favour  has  never  been  accepted  by  the 
majority  of  mankind.  Philosophers  have  vied 
with  each  other  in  depicting  the  evils  and  mis- 
eries incidental  to  existence,  and  the  truth  of 
their  descriptions  has  often  been  sorrowfully  ad- 
mitted, but  they  have  failed  to  dislodge,  or  even 
seriously  diminish,  that  desire  for  long  life 
which  has  been  deeply  implanted  within  the 
hearts  of  men.  The  question  whether  life  be 
worth  living  has  been  decided  by  a  majority 
far  too  great  to  admit  of  any  doubt  upon  the  sub- 
ject, and  the  voices  of  those  who  would  fain  reply 
in  the  negative  are  drowned  amid  the  chorus  of 
assent.  Longevity,  indeed,  has  come  to  be  re- 
garded as  one  of  the  grand  prizes  of  human  exist- 
ence, and  reason  has  again  and  again  suggested 
the  inquiry  whether  care  or  skill  can  increase  the 
chances  of  acquiring  it,  and  can  make  old  age, 
when  granted,  as  comfortable  and  happy  as 
any  other  stage  of  our  existence. 
107 


Masterpieces    of    Science 

From  very  early  times  the  art  of  prolonging 
life,  and  the  subject  of  longevity,  have  engaged 
the  attention  of  thinkers  and  essayists;  and  some 
may  perhaps  contend  that  these  topics,  admitted- 
ly full  of  interest,  have  been  thoroughly  ex- 
hausted. It  is  true  that  the  art  in  question  has 
long  been  recognized  and  practiced,  but  the 
science  upon  which  it  really  depends  is  of  quite 
modern  origin.  New  facts  connected  with 
longevity  have,  moreover,  been  collected  within 
the  last  few  years,  and  some  of  these  I  propose 
to  examine,  and  further  to  inquire  whether 
they  teach  us  any  fresh  means  whereby  life 
may  be  maintained  and  prolonged. 

But,  before  entering  upon  the  immediate 
subject,  there  are  several  preliminary  questions 
wliich  demand  a  brief  examination,  and  the 
first  that  suggests  itself  is.  What  is  the  natural 
duration  of  human  life?  This  oft-repeated 
question  has  received  many  different  answers; 
and  inquiry  has  been  stimulated  by  skepticism 
as  to  their  truth.  The  late  Sir  George  Come- 
wall  Lewis  expressed  the  opinion  that  one  hun- 
dred years  must  be  regarded  as  a  limit  which 
very  few,  if  indeed  any,  human  beings  succeed 
in  reaching,  and  he  supported  this  view  by  several 
cogent  reasons.  He  pointed  out  that  almost 
all  the  alleged  instances  of  abnormal  longevity 
occurred  among  the  humbler  classes,  and  that 
it  was  difficult,  if  not  impossible,  to  obtain  any 
exact  information  as  to  the  date  of  birth,  and 
to  identify  the  individuals  with  any  written 
108 


The    Art    of    Prolonging    Life 

statements  that  might  be  forthcoming.  He 
laid  particular  stress  upon  the  fact  that  similar 
instances  were  altogether  absent  among  the 
higher  classes,  with  regard  to  whom  trustworthy 
documentary  evidence  was  almost  always  ob- 
tainable. He  thought  that  the  higher  the  rank 
the  more  favourable  would  the  conditions  be  for 
the  attainment  of  a  long  life.  In  this  latter 
supposition,  however,  Sir  George  Lewis  was 
probably  mistaken:  the  comforts  and  luxuries 
appertaining  to  wealth  and  high  social  rank  are 
too  often  counterbalanced  by  cares  and  anxieties, 
and  by  modes  of  living  inconsistent  with  the 
maintenance  of  health,  and  therefore  with  the 
prolongation  of  life.  In  the  introduction  to 
his  work  on  "Human  Longevity,"  Easton  says, 
"It  is  not  the  rich  or  great  .  .  .  that  be- 
come old,  but  such  as  use  much  exercise,  are 
exposed  to  the  fresh  air,  and  whose  food  is  plain 
and  moderate — as  farmers,  gardeners,  fisher- 
men, labourers,  soldiers,  and  such  men  as  per- 
haps never  employed  their  thoughts  on  the 
means  used  to  promote  longevity." 

The  French  naturalist,  Buffon,  believed  that 
if  accidental  causes  could  be  excluded,  the  normal 
duration  of  human  life  would  be  between  ninety 
and  one  hundred  years,  and  he  suggested  that 
it  might  be  measured  (in  animal  as  well  as  in 
man)  by  the  period  of  growth,  to  which  it  stood 
in  a  certain  proportion.  He  imagined  that 
every  animal  might  live  for  six  or  seven  times 
as  many  years  as  were  requisite  for  the  com- 
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Masterpieces    of    Science 

pletion  of  its  growth.  But  this  calculation  is 
not  in  harmony  with  facts,  so  far,  at  least,  as 
man  is  concerned.  His  period  of  groTs-th  can- 
not be  estimated  at  less  than  twenty  years;  and 
if  we  take  the  lower  of  the  two  multipliers,  we 
get  a  ntmiber  which,  in  the  light  of  modern 
e\'idence,  can  not  be  accepted  as  attainable. 
If  the  period  of  growth  be  multiplied  by  five, 
the  result  will  in  all  probability  not  be  far  from 
the  truth. 

If  we  seek  historical  e\-idence,  and  from  it 
attempt  to  discover  the  extreme  limit  of  human 
life,  we  are  puzzled  at  the  differences  in  the  ages 
said  to  have  been  attained.  The  longest}"  of 
the  antediluvian  patriarchs  when  contrasted 
with  our  modem  experience  seems  incredible. 
When  we  look  at  an  indi^'idual,  say  ninety  years 
of  age,  taking  even  the  most  favourable  speci- 
men, a  prolongation  of  life  to  ten  times  that 
number  of  years  would  appear  too  absurd  even  to 
dream  about.  There  is  certainly  no  physiological 
reason  why  the  ages  assigned  to  the  patriarchs 
should  not  have  been  attained,  and  it  is  useless 
to  discuss  the  subject,  for  we  know  very  little  of 
the  conditions  under  which  they  lived.  It  is 
interesting  to  notice  that  after  the  Flood  there 
was  a  gradual  decrease  in  the  duration  of  life. 
Abraham  is  recorded  to  have  died  at  one  hundred 
and  seventy-five;  Joshua,  some  five  hundred 
years  later,  "waxed  old  and  stricken  in  age" 
shortly  before  his  death  at  one  himdred  and  ten 
years;  and  his  predecessor,  Moses,  to  whom  one 
110 


The    Art   of    Prolonging    Life 

hundred  and  twenty  years  are  assigned,  is  be- 
lieved to  have  estimated  the  life  of  man  at  three- 
score years  and  ten — a  measure  nowadays  pretty 
generally  accepted. 

There  is  no  reason  for  believing  that  the  ex- 
treme limit  of  human  life  in  the  time  of  the 
Greeks  and  Romans  differed  materially  from 
that  which  agrees  with  modem  experience. 
Stories  of  the  attainment  of  such  ages  as  one 
hundred  and  twenty  years  and  upward  may  be 
placed  in  the  same  category  as  the  reputed  lon- 
gevity of  Henry  Jenkins,  Thomas  Parr,  Lady 
Desmond,  and  a  host  of  others.  With  regard 
to  later  times,  such  as  the  middle  ages,  there  are 
no  precise  data  upon  which  any  statements  can 
be  based,  but  there  is  every  reason  to  believe 
that  the  average  duration  of  life  was  decidedly 
less  than  it  is  at  present.  The  extreme  limit, 
indeed,  three  or  four  centuries  ago,  would  ap- 
pear to  have  been  much  lower  than  in  the  nine- 
teenth century.  At  the  request  of  Mr.  Thoms, 
Sir  J.  Duffus  Hardy  investigated  the  subject  of 
the  longevity  of  man  in  the  thirteenth,  four- 
teenth, fifteenth,  and  sixteenth  centuries,  and 
his  researches  led  him  to  believe  that  persons 
seldom  reached  the  age  of  eighty.  He  never 
met  with  a  trustworthy  record  of  a  person  who 
exceeded  that  age. 

To  bring  the  investigation  down  to  quite  recent 
times,  I  can  not  do  better  than  utilize  the  re- 
searches of  Dr.  Humphry,  Professor  of  Surgery 
at  Cambridge.  In  1886  he  obtained  particu- 
111 


Masterpieces    of   Science 

lars  relating  to  fifty-two  individuals  then  living 
and  said  to  be  one  hundred  years  old  and  upward. 
The  oldest  among  them  claimed  to  be  one  hun- 
dred and  eight,  the  next  one  hundred  and  six, 
while  the  average  amounted  to  a  little  more  than 
one  hundred  and  two  )-ears.  Many  interesting 
facts  connected  with  the  habits  and  mode  of 
life  of  these  individuals  were  obtained  by  Dr. 
Humphry- ,  and  will  be  referred  to  in  subse- 
quent paragraphs. 

A  short  account  of  the  experience  of  a  few 
life-assurance  companies  will  conclude  this  part 
of  my  subject.  Mr.  Thoms  tells  us  that  down 
to  1872  the  records  of  the  companies  showed 
that  one  death  among  the  assured  had  occurred 
at  one  hundred  and  three,  one  in  the  one  hun- 
dredth, and  three  in  the  ninety-ninth  year.  The 
experience  of  the  National  Debt  Office,  according 
to  the  same  authority,  gave  two  cases  in  which 
the  e\4dence  could  be  regarded  as  perfect;  one 
of  these  died  in  the  one  hundred  and  second 
3"ear,  and  the  other  had  just  completed  that 
number.  In  the  tables  published  by  the  Insti- 
tute of  Actuaries,  and  giving  the  mortality  ex- 
perience dowTi  to  1863  of  twenty  life-assurance 
companies,  the  highest  age  at  death  is  recorded 
as  ninety-nine;  and  I  am  informed  by  the  secre- 
tary of  the  Edinburgh  Life  Office  that  from  1863 
onward  that  age  had  not  been  exceeded  in  his 
experience.  In  the  valuation  schedules,  which 
show  the  highest  ages  of  existing  lives  in  various 
offices,  the  ages  range  from  ninety-two  to  ninety- 
112 


The  Art  of    Prolonging   Life 

five.  It  is  true  that  one  office  which  has  a  large 
business  among  the  industrial  classes  reports 
lives  at  one  hundred  and  three,  and  in  one  in- 
stance at  one  hundred  and  seven;  but  it  must  be 
remembered  that  among  those  classes  the  ages 
are  not  nearly  so  well  authenticated  as  among 
those  who  assure  for  substantial  sums.  There 
is,  moreover,  another  source  of  error  connected 
with  the  valuation  schedules.  When  a  given 
life  is  not  considered  to  be  equal  to  the  average, 
a  certain  number  of  years  is  added  to  the  age, 
and  the  premium  is  charged  at  the  age  which 
results  from  this  addition.  It  follows,  there- 
fore, that  in  some  cases  the  age  given  in  the 
schedules  are  greater  by  some  years  than  they 
really  are. 

Taking  into  consideration  the  facts  thus 
rapidly  passed  under  review,  it  must,  I  think, 
be  admitted  that-  the  natural  limit  of  human 
existence  is  that  assigned  to  it  in  the  book  of 
Ecclesiasticus,  "The  number  of  a  man's  days  at 
the  most  are  an  hundred  years"  (chapter  xviii. 
g).  In  a  very  small  number  of  cases  this  limit 
is  exceeded,  but  only  by  a  very  few  years.  Mr. 
Thoms's  investigations  conclusively  show  that 
trustworthy  evidence  of  one  hundred  and  ten 
years  having  been  reached  is  altogether  absent. 
Future  generations  will  be  able  to  verify  or  re- 
ject statements  in  all  alleged  cases  of  longevity. 
It  must  be  remembered  that  previous  to  the 
year  1836  there  was  no  registration  of  births, 
but  only  of  baptisms,  and  that  the  registers 
113 


Masterpieces   of   Science 

were  kept  in  the  churches,  and  contained  only 
the  names  of  those  therein  baptized. 

Whatever  number  of  years  may  be  taken  as 
representing  the  natural  term  of  human  life, 
whether  threescore  and  ten  or  a  century  be  re- 
garded as  such,  we  are  confronted  by  the  fact 
that  only  one-fourth  of  our  population  attains 
the  former  age,  and  that  only  about  fifteen  in 
one  hundred  thousand  become  centenarians. 
Tt  is  beyond  the  scope  of  this  article  to  discuss 
Lhe  causes  of  premature  mortality,  but  the  con- 
ditions favourable  to  longevity,  and  the  causes 
to  which  length  of  days  has  been  assigned,  are 
closely  connected  with  its  subject. 

A  capability  of  attaining  old  age  is  very  often 
handed  down  from  one  generation  to  another, 
and  heredity  is  probably  the  most  powerful 
factor  in  connection  with  longevity.  A  neces- 
sary condition  of  reaching  advanced  age  is  the 
possession  of  sound  bodih-  organs,  and  such  an 
endowment  is  eminently  capable  of  transmission. 
Instances  of  longevity  characterizing  several 
generations  are  frequently  brought  to  notice.  A 
recent  and  most  interesting  example  of  trans- 
mitted longevity  is  that  of  the  veteran  guardian 
of  the  public  health.  Sir  Edwin  Chadwick,  who 
was  entertained  at  a  public  dinner  a  few  weeks 
ago  on  the  occasion  of  his  reaching  his  ninetieth 
year.  He  informed  his  entertainers  that  his 
father  died  at  the  age  of  eighty-four,  one  of  his 
grandfathers  at  ninet^'^-five,  and  that  two  more 
remote  ancestors  were  centenarians. 
114 


The  Art  of    Prolonging    Life 

It  is  difficult  to  estimate  the  influence  of  other 
contingencies  which  affect  longevity.  With  re- 
gard to  sex,  Hufeland's  opinion  was  that  women 
were  more  likely  than  men  to  become  old,  but 
that  instances  of  extreme  longevity  were  more 
frequent  among  men.  This  opinion  is  to  some 
extent  borne  out  by  Dr.  Humphry's  statistics: 
of  fifty-two  centenarians,  thirty-six  were  women. 
Marriage  would  appear  to  be  conducive  to  lon- 
gevity. A  well-known  French  savant,  Dr.  Ber- 
tillon,  states  that  a  bachelor  of  twenty-five  is  not 
a  better  life  than  a  married  man  of  forty-five, 
and  he  attributes  the  difference  in  favour  of 
married  people  to  the  fact  that  they  take  more 
care  of  themselves,  and  lead  more  regular  lives 
than  those  who  have  no  such  tie.  It  must, 
however,  be  remembered  that  the  mere  fact 
of  marrying  indicates  superior  vitality  and  vigour, 
and  the  ranks  of  the  unmarried  are  largely  filled 
by  the  physically  unfit. 

In  considering  occupations  as  they  are  likely 
to  effect  longevity,  those  which  obviously  tend 
to  shorten  life  need  not  be  considered.  With 
respect  to  the  learned  professions,  it  would  ap- 
pear that  among  the  clergy  the  average  of  life 
is  beyond  that  of  any  similar  class.  It  is  im- 
probable that  this  average  will  be  maintained 
for  the  future;  the  duties  and  anxieties  imposed 
upon  the  clergy  of  the  present  generation  place 
them  in  a  very  different  position  from  that  of 
their  predecessors.  Among  lawyers  there  have 
been  several  eminent  judges  who  attained  a  great 
115 


Masterpieces   of   Science 

age,  and  the  rank  and  file  of  the  profession  are 
also  characterized  by  a  decided  tendency  to 
longevity.  The  medical  profession  supplies  but 
few  instances  of  extreme  old  age,  and  the  average 
duration  of  life  among  its  members  is  decidedly 
low,  a  fact  which  can  be  easily  accounted  for. 
Broken  rest,  hard  work,  anxieties,  exposure  to 
weather  and  to  the  risks  of  infection  can  not  fail 
to  exert  an  injurious  influence  upon  health. 
No  definite  conclusions  can  be  arrived  at  with 
regard  to  the  average  longevity  of  literary  and 
scientific  men,  but  it  might  be  supposed  that 
those  among  them  who  are  not  harassed  by 
anxieties  and  enjoy  fair  health  would  probably 
reach  old  age.  As  a  general  rule,  the  duration 
of  life  is  not  shortened  by  literary  pursuits.  A 
man  may  worr}^  himself  to  death  over  his  books, 
or,  when  tired  of  them,  may  seek  recreation  in 
pursuits  destructive  to  health;  but  application 
to  literars^  work  tends  to  produce  cheerfulness, 
and  to  prolong  rather  than  shorten  the  life  even 
of  an  infirm  man.  In  Prof.  Humphr>^'s  "Re- 
port on  Aged  Persons,"  containing  an  account 
of  eight  hundred  and  twenty-four  individuals 
of  both  sexes,  and  between  the  ages  of  eighty 
and  one  hundred,  it  is  stated  that  forty-eight 
per  cent,  were  poor,  forty-two  per  cent,  were  in 
comfortable  circumstances,  and  only  ten  per 
cent,  were  described  as  being  in  affluent  circum- 
stances. Dr.  Himiphry  points  out  that  these 
ratios  "must  not  be  regarded  as  representing 
the  relations  of  poverty  and  affluence  to  lon- 
116 


The   Art   of    Prolonging    Life 

gevity,  because,  in  the  first  place,  the  poor  at  all 
ages  and  in  all  districts  bear  a  large  proportion 
to  the  affluent;  and,  secondly,  the  returns  are 
largely  made  from  the  lower  and  iniddle  classes, 
and  in  many  instances  from  the  inmates  of 
union  work-houses,  where  a  good  number  of 
aged  people  are  found."  It  must  also  be  noticed 
that  the  "past  life-history"  of  these  individuals 
showed  that  the  greater  proportion  (fifty-five 
per  cent.)  "had  lived  in  comfortable  circum- 
stances." and  that  only  thirty-five  percent,  had 
been  poor. 

Merely  to  enumerate  the  causes  to  which  lon- 
gevity has  been  attributed  in  attempting  to  ac- 
count for  individual  cases  would  be  a  task  of  some 
magnitude;  it  will  be  sufficient  to  mention  a 
few  somewhat  probable  theories.  Moderation 
in  eating  and  drinking  is  often  declared  to  be  a 
cause  of  longevity,  and  the  assertion  is  fully 
corroborated  by  Dr.  Humphry's  inquiries.  Of 
his  fifty-two  centenarians,  twelve  were  recorded 
as  total  abstainers  from  alcoholic  drinks  through- 
out life,  or  for  long  periods;  twenty  had  taken 
very  little  alcohol;  eight  were  reported  as  mod- 
erate in  their  use  of  it;  and  only  three  habitually 
indulged  in  it.  It  is  quite  true  that  a  few  per- 
sons who  must  be  classified  as  drunkards  live 
to  be  very  old;  but  these  are  exceptions  to  the 
general  rule,  and  such  cases  appear  to  be  more 
frequent  than  they  really  are,  because  they  are 
often  brought  to  notice  by  those  who  find  en- 
couragement from  such  examples.  The  habit 
117 


Masterpieces    of   Science 

of  temperance  in  food,  good  powers  of  digestion, 
and  soundness  of  sleep  are  other  main  character- 
istics of  most  of  those  who  attain  advanced  years, 
and  may  be  regarded  as  causes  of  longevity. 
Not  a  few  old  persons  are  found  on  inquiry  to 
take  credit  to  themselves  for  their  own  con- 
dition, and  to  attribute  it  to  some  remarkable 
peculiarity  in  their  habits  or  mode  of  life.  It 
is  said  that  Lord  Mansfield,  who  reached  the 
age  of  eighty-nine,  was  wont  to  inquire  into  the 
habits  of  life  of  all  aged  witnesses  who  appeared 
before  him,  and  that  only  in  one  habit,  namely, 
that  of  early  rising,  was  there  any  general  con- 
currence. Health  is  doubtless  often  promoted 
by  early  rising,  but  the  habit  is  not  necessarily 
conducive  to  longevity.  It  is,  as  Sir  H.  Holland 
points  out,  more  probable  that  the  vigour  of  the 
individuals  maintains  the  habit  than  that  the 
latter  alone  maintains  the  vitality. 

If  we  pass  from  probable  to  improbable  causes 
of  longevity  we  are  confronted  by  many  extrava- 
gant assumptions.  Thus,  to  take  only  a  few 
examples,  the  immoderate  use  of  sugar  has  been 
regarded  not  only  as  a  panacea,  but  as  decidedly 
conducive  to  length  of  days.  Dr.  Slare,  a  phy- 
sician of  the  last  centurj-,  has  recorded  the  case 
of  a  centenarian  who  used  to  mix  sugar  with  all 
his  food,  and  the  doctor  himself  was  so  con- 
vinced of  the  "balsamic  virtue"  of  this  sub- 
stance that  he  adopted  the  practice,  and  boasted 
of  his  health  and  strength  in  his  old  age.  An- 
other member  of  the  same  profession  used  to 
118 


The  Art  of    Prolonging    Life 

take  daily  doses  of  tannin  (the  substance  em- 
ployed to  harden  and  preserve  leather),  under 
the  impression  that  the  tissues  of  the  body  would 
be  thereby  protected  from  decay.  His  life  was 
protracted  beyond  the  ordinary  span,  but  it  is 
questionable  whether  the  tannin  acted  in  the 
desired  direction.  Lord  Combermere  thought 
that  his  good  health  and  advanced  years  were 
due,  in  part  at  least,  to  the  fact  that  he  always 
wore  a  tight  belt  round  his  waist.  His  lord- 
ship's appetite  was  doubtless  thereby  kept 
within  bounds;  we  are  further  told  that  he  was 
very  moderate  in  the  use  of  all  fluids  as  drink. 
Cleanliness  might  be  supposed  to  aid  in  pro- 
longing life,  yet  a  Mrs.  Lewson,  who  died  in  the 
early  part  of  this  centur3>,  aged  one  hundred  and 
six,  must  have  been  a  smgularly  dirty  person. 
We  are  told  that  instead  of  washing  she  smeared 
her  face  with  lard,  and  asserted  that  "people 
who  washed  always  caught  cold."  This  lady, 
no  doubt,  was  fully  persuaded  that  she  had  dis- 
covered the  universal  medicine. 

Many  of  the  alchemists  attributed  the  power 
of  prolonging  life  to  certain  preparations  of 
gold,  probably  under  the  idea  that  the  perma- 
nence of  the  metal  might  be  imparted  to  the  hu- 
man system.  Descartes  is  said  to  have  favoured 
such  opinions;  he  told  Sir  Kenelm  Digby  that, 
although  he  would  not  venture  to  promise  im- 
mortality, he  was  certain  that  his  life  might  be 
lengthened  to  the  period  of  that  enjoyed  by 
the  patriarchs.  His  plan,  however,  seems  to 
119 


Masterpieces   of   Science 

have  been  the  very  rational  and  simple  one  of 
checking  all  excesses  and  enjoining  piinctual  and 
frugal  meals. 

Ha\'ing  thus  endeavoured  to  show  the  extent 
to  which  human  life  may  be  prolonged,  and 
ha\ang  examined  some  of  the  causes  or  ante- 
cedents of  longevity,  the  last  subject  for  inquiry 
is  the  means  by  which  it  may  be  attained. 
Certain  preliminary  conditions  are  obviously 
requisite ;  in  the  first  place  there  must  be  a  sound 
constitution  derived  from  healthy  ancestors, 
and  in  the  second  there  must  be  a  freedom  from 
organic  disease  of  important  organs.  Given 
an  indiA-idual  who  has  reached  the  grand  climac- 
teric, or  threescore  and  ten.  and  in  whom  these 
two  conditions  are  fulfilled,  the  means  best 
adapted  to  maintain  and  prolong  his  life  con- 
stitute the  question  to  be  solved.  It  has  been 
said  that  "he  who  would  long  to  be  an  old  man 
must  begin  early  to  be  one,"  but  very  few  per- 
sons designedly  take  measures  in  early  life  in 
order  that  they  may  live  longer  than  their 
fellows. 

The  whole  term  of  life  may  be  divided  into 
the  three  main  periods  of  growth  and  develop- 
ment, of  mattu-ity,  and  of  decline.  No  hard  and 
fast  line  can  be  drawn  between  these  two  latter 
phases  of  existence:  the  one  should  pass  gradu- 
ally into  the  other  until  the  entire  picture  is 
changed.  Diminished  conservative  power  and 
the  consequent  triumph  of  disintegrating  forces 
are  the  prominent  features  of  the  third  period, 
120 


The   Art   of    Prolonging   Life 

which  begins  at  different  times  in  different  in- 
dividuals, its  advent  being  mainly  controlled  by 
the  general  course  of  the  preceding  years.  The 
"turning  period,"  also  known  as  the  "climac- 
teric" or  "middle  age,"  lies  between  forty-five 
and  sixty;  the  period  beyond  may  be  considered 
as  belonging  to  advanced  life  or  old  age.  The 
majority  of  the  changes  characteristic  of  these 
last  stages  are  easily  recognizable.  It  is  hardly 
necessary  to  mention  the  wrinkled  skin,  the 
furrowed  face,  the  "crow's  feet"  beneath  the 
eyes,  the  stooping  gait,  and  the  wasting  of  the 
frame.  The  senses,  notably  vision  and  hearing, 
become  less  acute;  the  power  of  digestion  is 
lessened;  the  force  of  the  heart  is  diminished; 
the  lungs  are  less  permeable;  many  of  the  air- 
cells  lose  their  elasticity  and  merge  into  each 
other,  so  that  there  is  less  breathing  surface  as 
well  as  less  power.  Simultaneously  with  these 
changes  the  mind  may  present  signs  of  en- 
feeblement;  but  in  many  instances  its  powers 
long  remain  in  marked  contrast  with  those  of 
the  body.  One  fact  connected  with  advanced 
life  is  too  often  neglected.  It  should  never  be 
forgotten  that  while  the  "forces  in  use"  at  that 
period  are  easily  exhausted,  the  "forces  in  re- 
serve" are  often  so  slight  as  to  be  unable  to  meet 
the  smallest  demand.  In  youth,  the  reserve 
powers  are  superabundant;  in  advanced  life, 
they  are  reduced  to  a  minimum,  and  in  some 
instances  are  practically  non-existent.  The 
recognition  of  this  difference  is  an  all-important 
121 


Masterpieces   of   Science 

gtdde  in  laying  down  rules  for    conduct  in  old 
age. 

In  order  to  prolong  life  and  at  the  same  time 
to  enjoy  it,  occupation  of  some  kind  is  abso- 
lutely necessary-;  it  is  a  great  mistake  to  suppose 
that  idleness  is  conducive  to  longevity.  It  is 
at  all  times  better  to  wear  out  than  to  rust  out, 
and  the  latter  process  is  apt  to  be  speedily  ac- 
complished. Ever\-  one  must  have  met  with  in- 
di\'i duals  who,  while  fully  occupied  till  sixty  or 
even  seventy  years  of  age,  remained  hale  and 
strong,  but  aged  with  mar\'elous  rapidity  after 
relinquishing  work,  a  change  in  their  mental 
condition  becoming  especially  prominent.  There 
is  an  obvious  lesson  to  be  learned  from  such  in- 
stances, but  certain  qualifications  are  neces- 
sary^ in  order  to  apply  it  properly.  With  regard 
to  mental  activity,  there  is  abundant  evidence 
that  the  more  the  intellectual  faculties  are  exer- 
cised the  greater  the  probability  of  their  lasting. 
They  often  become  stronger  after  the  vital  force 
has  passed  its  culminating  point;  and  this  re- 
tention of  mental  power  is  the  true  compensa- 
tion for  the  decline  in  bodily  strength.  Did 
space  permit,  many  illustrations  coiild  be  ad- 
duced to  show  that  the  power  of  the  mind  can 
be  preser\-ed  almost  unimpaired  to  the  most 
advanced  age.  Even  memor}-,  the  failure  of 
which  is  sometimes  regarded  as  a  necessary  con- 
comitant of  old  age,  is  not  infrequently  preserved 
almost  up  to  the  end  of  life.  All  persons  of 
middle  age  should  take  special  pains  to  keep  the 
122 


The   Art   of    Proloriging    Life 

faculties  and  energies  of  the  mind  in  a  vigorous 
condition;  they  should  not  simply  drift  on  in  a 
haphazard  fashion,  but  should  seek  and  find 
pleasure  in  the  attainment  of  definite  objects. 
Even  if  the  mind  has  not  been  especially  culti- 
vated, or  received  any  decided  bent,  there  is  at 
the  present  day  no  lack  of  subjects  on  which  it 
can  be  agreeably  and  profitably  exercised. 
Many  sciences  which,  twenty  or  thirty  years  ago, 
were  accessible  only  to  the  few,  and  wore  at  best 
a  somewhat  uninviting  garb,  have  been  rendered 
not  merely  intelligible  but  even  attractive  to  the 
many;  and  in  the  domain  of  general  literature 
the  difficulty  of  making  a  choice  among  the  host  of 
allurements  is  the  only  ground  for  complaint. 
To  increase  the  taste  for  these  and  kindred  sub- 
jects is  worth  a  considerable  effort,  if  such  be 
necessary;  but  the  appetite  will  generally  come 
with  the  eating.  The  possession  of  some  rea- 
sonable hobby  which  can  be  cultivated  indoors 
is  a  great  advantage  in  old  age,  and  there  are 
many  pursuits  of  this  character  besides  those 
connected  with  literature  and  science.  Talley- 
rand laid  great  stress  on  a  knowledge  of  whist  as 
indispensable  to  a  happj^^  old  age,  and  doubt- 
less to  many  old  people  that  particular  game 
affords  not  only  recreation  but  a  pleasant  ex- 
ercise to  the  mind.  It  is,  however,  an  unworthy 
substitute  for  higher  objects,  and  should  be  re- 
garded only  as  an  amusement  and  not  as  an 
occupation. 

Whatever  be  the  sphere  of  mental  activity, 
123 


Masterpieces   of   Science 

no  kind  of  strain  must  be  put  upon  the  mind  by  a 
person  who  has  reached  sixty-five  or  seventy 
years.  The  feeling  that  mental  power  is  less 
than  it  once  was  not  infrequently  stimulates 
a  man  to  increased  exertions  which  may  pro- 
voke structural  changes  in  the  brain,  and  will 
certainly  accelerate  the  progress  of  any  that 
may  exist  in  that  organ.  When  a  man  finds 
that  a  great  effort  is  required  to  accomplish 
any  mental  task  that  was  once  easy,  he  should 
desist  from  the  attempt,  and  regulate  his  work 
according  to  his  power.  With  this  limita- 
tion, it  may  be  taken  for  granted  that  the  mental 
facilities  will  be  far  better  preserved  by  their 
exercise  than  by  their  disuse. 

Somewhat  different  advice  must  be  given  with 
regard  to  bodily  exercises  in  their  reference  to 
longevity.  Exercise  is  essential  to  the  preser\^a- 
tion  of  health;  inactivity  is  a  potent  cause  of 
wasting  and  degeneration.  The  vigour  and 
equality  of  the  circulation,  the  functions  of  the 
skin,  and  the  aeration  of  the  blood,  are  all  pro- 
moted by  muscular  activity,  which  thus  keeps  up 
a  proper  balance  and  relation  between  the  im- 
portant organs  of  the  body.  In  youth,  the 
vigour  of  the  system  is  often  so  great  that  if  one 
organ  be  sluggish  another  part  will  make  amends 
for  the  deficiency  by  acting  vicariously,  and 
without  any  consequent  damage  to  itself.  In 
old  age,  the  tasks  can  not  be  thus  shifted  from 
one  organ  to  another;  the  work  allotted  to  each 
sufficiently  taxes  its  strength,  and  vicarious 
124 


The  Art   of    Prolonging    Life 

aciton  can  not  be  performed  without  mischief. 
Hence  the  importance  of  maintaining,  as  far  as 
possible,  the  equable  action  of  all  the  bodily 
organs,  so  that  the  share  of  the  vital  processes 
assigned  to  each  shall  be  properly  accomplished. 
For  this  reason  exercise  is  an  important  part  of 
the  conduct  of  life  in  old  age;  but  discretion  is 
absolutely  necessar}^  An  old  man  should  dis- 
cover by  experience  how  much  exercise  he  can 
take  without  exhausting  his  powers,  and  should 
be  careful  never  to  exceed  the  limit.  Old  per- 
sons are  apt  to  forget  that  their  staying  powers 
are  much  less  than  they  once  were,  and  that, 
while  a  walk  of  two  or  three  miles  may  prove 
easy  and  pleasurable,  the  addition  of  a  return 
journey  of  similar  length  will  seriously  overtax 
the  strength.  Above  all  things,  sudden  and 
rapid  exertion  should  be  scrupulously  avoided 
by  persons  of  advanced  age.  The  machine 
which  might  go  on  working  for  years  at  a  gentle 
pace  often  breaks  down  altogether  when  its 
movements  are  suddenly  accelerated.  These 
cautions  may  appear  superfluous,  but  instances 
in  which  their  disregard  is  followed  by  very 
serious  consequences  are  by  no  means  infre- 
quent. 

No  fixed  rule  can  be  laid  down  as  to  the  kind 
of  exercise  most  suitable  for  advanced  age. 
Much  must  depend  upon  individual  circum- 
stances and  peculiarities;  but  walking  in  the 
open  air  should  always  be  kept  up  and  practiced 
daily,  except  in  unfavourable  weather.  Walking 
125 


Masterpieces   of   Science 

is  a  natural  form  of  exercise  and  subserves 
many  important  purposes:  not  a  few  old  people 
owe  the  maintenance  of  their  health  and  vigour 
to  their  daily  "constitutional."  Riding  is  an 
excellent  form  of  exercise,  but  available  only  by 
a  few;  the  habit,  if  acquired  in  early  life,  should 
be  kept  up  as  long  as  possible,  subject  to  the 
caution  already  given  as  to  violent  exercise. 
Old  persons  of  both  sexes  fond  of  gardening,  and 
so  situated  that  they  may  gratify  their  tastes, 
are  much  to  be  envied.  Body  and  mind  are 
alike  exercised  by  what  Lord  Bacon  justly 
termed  "the  ptirest  of  human  pleasures."  Dr. 
Parkes  goes  so  far  as  to  say  that  light  garden  or 
agricultxiral  work  is  a  very  good  exercise  for 
men  past  seventy:  "It  calls  into  play  the  muscles 
of  the  abdomen  and  back,  which  in  old  men  are 
often  but  little  used,  and  the  work  is  so  varied 
that  no  muscle  is  kept  long  in  action."  A  few 
remarks  must  be  made,  in  conclusion,  with  re- 
gard to  a  new  form  of  exercise  sometimes  in- 
dulged in  even  by  elderly  men.  I  allude  to 
so-called  "  tricycling."  Exhilarating  and  pleas- 
ant as  it  may  be  to  glide  over  the  ground  with 
comparatively  little  effort,  the  exercise  is  fraught 
with  danger  for  men  who  have  passed  the  grand 
climacteric.  The  temptation  to  make  a  spurt 
must  be  often  irresistible;  hills  must  be  encoun- 
tered, some  perhaps  so  smooth  and  gradual  as  to 
require  no  special  exertion,  none,  at  least,  that 
is  noticed  in  the  triumph  of  surmotmting  them. 
Now,  if  the  heart  and  lungs  be  perfectly  sound, 
126 


The  Art  of    Prolonging    Life 

such  exercises  may  be  practiced  for  some  time 
with  apparent  impunity;  but  if  (as  is  very  likely 
to  be  the  case)  these  organs  be  not  quite  struc- 
turally perfect,  even  the  slightest  changes  will, 
under  such  excitement,  rapidly  progress  and 
lead  to  very  serious  results.  Exercise  unsuited 
to  the  state  of  the  system  will  assuredly  not 
tend  to  the  prolongation  of  life. 

With  regard  to  food,  we  find  from  Dr.  Hum- 
phry's report  that  ninety  per  cent,  of  the  aged 
persons  were  either  "moderate"  or  "small" 
eaters,  and  such  moderation  is  quite  in  accord 
with  the  teachings  of  physiology.  In  old  age  the 
changes  in  the  bodily  tissues  gradually  become 
less  and  less  active,  and  less  food  is  required  to 
make  up  for  the  daily  waste.  The  appetite  and 
the  power  of  digestion  are  correspondingly  di- 
minished, and  although  for  the  attainment  of  a 
great  age  a  considerable  amount  of  digestive 
power  is  absolutely  necessary,  its  perfection, 
when  exercised  upon  proper  articles  of  diet,  is 
the  most  important  characteristic.  Indulgence 
in  the  pleasures  of  the  table  is  one  of  the  com- 
mon errors  of  advanced  life,  and  is  not  infre- 
quent in  persons  who,  up  to  that  period,  were 
moderate  or  even  small  eaters.  Luxuries  in 
the  way  of  food  are  apt  to  be  regarded  as  re- 
wards that  have  been  fully  earned  by  a  life  of 
labour,  and  may,  therefore,  be  lawfully  enjoyed. 
Hence  arise  many  of  the  evils  and  troubles  of 
old  age,  and  notably  indigestion  and  gouty 
symptoms  in  various  forms,  besides  mental  dis- 
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Masterpieces   of   Science 

comfort.  No  hard  and  fast  rules  can  be  laid 
down,  but  strict  moderation  should  be  the  guid- 
ing maxim.  The  diet  suitable  for  most  aged 
persons  is  that  which  contains  much  nutritive 
material  in  a  small  bulk,  and  its  quantity  should 
be  in  proportion  to  the  appetite  and  power  of 
digestion.  Animal  food,  well  cooked,  should 
be  taken  sparingly  and  not  more  often  than 
twice  a  day,  except  imder  special  circiunstances. 
Dr.  Parkes  advocates  rice  as  a  partial  substi- 
tute for  meat  when  the  latter  is  fotmd  to  dis- 
agree with  old  persons.  "Its  starch-grains  are 
very  digestible,  and  it  suppHes  nitrogen  in 
moderate  amount,  well  fitted  to  the  worn  and 
slowly  repaired  tissues  of  the  aged."  Its  bulk, 
however,  is  sometimes  a  disadvantage;  in  small 
quantities  it  is  a  valuable  addition  to  milk  and 
to  stewed  fruits. 

The  amount  of  food  taken  should  be  divided 
between  three  or  four  meals  at  fairly  regular 
inters^als.  A  sense  of  fullness  or  oppression 
after  eating  ought  not  to  be  disregarded.  It 
indicates  that  the  food  taken  has  been  either 
too  abimdant  or  of  improper  quahty.  For  many 
elderly  people  the  most  suitable  time  for  the  prin- 
cipal meal  is  between  i  and  2  p.  m.  As  the  day 
advances  the  digestive  powers  become  less,  and 
even  a  moderately  substantial  meal  taken  in  the 
evening  may  seriously  overtask  them.  Undi- 
gested food  is  a  potent  cause  of  disturbed  sleep, 
an  evil  often  ver\^  troublesome  to  old  people,  and 
one  which  ought  to  be  carefully  guarded  against. 
128 


The   Art   of    Prolonging    Life 

It  is  an  easier  task  to  lay  down  rules  with  re- 
gard to  the  use  of  alcoholic  liquors  by  elderly 
people.  The  Collective  Investigation  Com- 
mittee of  the  British  Medical  Association  has 
lately  issued  a  "Report  on  the  Connection  of 
Disease  with  Habits  of  Intemperance,"  and  two 
at  least  of  the  conclusions  arrived  at  are  worth 
quoting:  "Habitual  indulgence  in  alcoholic 
liquors,  beyond  the  most  moderate  amount,  has 
a  distinct  tendency  to  shorten  life,  the  average 
shortening  being  roughly  proportional  to  the 
degree  of  indulgence.  Total  abstinence  and 
habitual  temperance  augment  considerably  the 
chance  of  death  from  old  age  or  natural  decay, 
without  special  pathological  lesion."  Subject, 
however,  to  a  few  exceptions,  it  is  not  advisable 
that  a  man  sixty-five  or  seventy  years  of  age, 
who  has  taken  alcohol  in  moderation  all  his  life, 
should  suddenly  become  an  abstainer.  Old 
age  can  not  readily  accommodate  itself  to  changes 
of  any  kind,  and  to  many  old  people  a  little  good 
wine  with  their  meals  is  a  source  of  great  com- 
fort. To  quote  again  from  Ecclesiasticus,  "Wine 
is  as  good  as  life  to  a  man,  if  it  be  drunk  moder- 
ately, for  it  was  made  to  make  men  glad." 
Elderly  persons,  particularly  at  the  close  of  the 
day,  often  find  that  their  nervous  energy  is  ex- 
hausted, and  require  a  little  stimulant  to  in- 
duce them  to  take  a  necessary  supply  of  proper 
nourishment,  and  perhaps  to  aid  the  digestive 
powers  to  convert  their  food  to  a  useful  purpose. 
In  the  debility  of  old  age,  and  especially  when 
129 


Masterpieces   of   Science 

sleeplessness  is  accompanied  by  slow  and  im- 
perfect digestion,  a  small  quantity  of  a  generous 
and  potent  wine,  containing  much  ether,  often 
does  good  ser^-ice.  Even  a  little  beer  improves 
digestion  in  some  old  people;  others  find  that 
spirits,  largely  diluted,  fulfill  the  same  purpose. 
Indi\"idual  peculiarities  must  be  allowed  for; 
the  only  general  rule  is  that  which  prescribes 
strict  moderation. 

It  is  not  to  be  inferred  from  the  hints  given 
in  the  preceding  paragraphs  that  the  preserva- 
tion of  health  should  be  the  predominant  thought 
in  the  minds  of  elderly  persons  who  desire  that 
their  lives  should  be  prolonged.  To  be  always 
guarding  against  disease,  and  to  live  in  a  state  of 
constant  fear  and  watchfulness,  would  make 
existence  miserable  and  hasten  the  progress  of 
decay.  Selfish  and  undue  solicitude  with  regard 
to  health  not  only  fails  to  attain  its  object, 
but  is  apt  to  induce  that  diseased  condition 
of  mind  known  as  hypochondriasis,  ["the  blues,"] 
the  \4ctims  of  which  are  always  a  burden  and  a 
nuisance,  if  not  to  themselves,  at  least  to  all 
connected  with  them.  Addison,  in  the  Spec- 
tator, after  describing  the  valetudinarian  who 
constantly  weighed  himself  and  his  food,  and 
yet  became  sick  and  languishing,  aptly  remarks, 
"A  continual  anxiety  for  life  \-itiates  all  the 
relishes  of  it,  and  casts  a  gloom  over  the  whole 
face  of  nature,  as  it  is  impossible  that  we  shoiild 
take  delight  in  anything  that  we  are  every  mo- 
ment afraid  of  losing." 

130 


The   Art   of    Prolonging    Life 

Sleep  is  closely  connected  with  the  question  of 
diet;  "good  sleeping"  was  a  noticable  feature  in 
the  large  majority  of  Dr.  Humphry's  cases. 
Sound,  refreshing  sleep  is  of  the  utmost  conse- 
quence to  the  health  of  the  body,  and  no  sub- 
stitute can  be  found  for  it  as  a  restorer  of  vital 
energy.  Sleeplessness  is,  however,  often  a 
source  of  great  trouble  to  elderly  people,  and 
one  which  is  not  easily  relieved.  Narcotic 
remedies  are  generally  mischievous;  their  first 
effects  may  be  pleasant,  but  the  habit  of  de- 
pending upon  them  rapidly  grows  until  they 
become  indispensable.  When  this  stage  has 
been  reached,  the  sufferer  is  in  a  far  worse  plight 
than  before.  In  all  cases  the  endeavour  should 
be  made  to  discover  whether  the  sleeplessness 
be  due  to  any  removable  cause — such  as  indi- 
gestion, cold,  want  of  exercise,  and  the  like.  In 
regard  to  sleeping  in  the  daytime,  there  is  some- 
thing to  be  said  both  for  and  against  that  prac- 
tice. A  nap  of  "forty  winks"  in  the  afternoon 
enables  many  aged  people  to  get  through  the 
rest  of  the  day  in  comfort,  whereas  they  feel 
tired  and  weak  when  deprived  of  this  refresh- 
ment. If  they  rest  well  at  night  there  can  be 
no  objection  to  the  afternoon  nap;  but  if  sleep- 
lessness be  complained  of,  the  latter  should  be 
discontinued  for  a  time.  Most  old  people  find 
that  a  reclining  posture,  with  the  feet  and  legs 
raised,  is  better  than  the  horizontal  position  for 
the  afternoon  nap.  Digestion  proceeds  with  more 
ease  than  when  the  body  is  recumbent. 
131 


Masterpieces   of   Science 

Warmth  is  very  important  for  the  aged;  ex- 
posure to  chills  should  be  scrupulously  avoided. 
Bronchitis  is  the  malady  most  to  be  feared, 
and  its  attacks  are  very  easily  provoked.  Many 
old  people  suffer  from  more  or  less  cough  during 
the  winter  months,  and  this  symptom  may  recur 
year  after  year,  and  be  almost  unheeded.  At 
last,  perhaps  a  few  minutes'  exposure  to  a  cold 
wind  increases  the  irritation  in  the  lungs,  the 
cough  becomes  worse,  and  the  difficulty  of 
breathing  increases  until  suffocation  terminates 
in  death.  To  obviate  such  risk  the  skin  should 
be  carefully  protected  by  warm  flannel  clothes, 
the  outdoor  thermometer  should  be  noticed 
and  winter  garments  should  always  be  at  hand. 
In  cold  weather  the  lungs  should  be  protected  by 
breathing  through  the  nose  as  much  as  possible, 
and  by  wearing  a  light  woolen  or  silken  muffler 
over  the  mouth.  The  temperature  of  the 
sitting  and  bed-rooms  is  another  point  which 
requires  attention.  Some  old  people  pride  them- 
selves on  never  requiring  a  fire  in  their  bed- 
rooms. It  is,  however,  a  risky  practice  to  ex- 
change a  temperature  of  65°  or  70°  for  one  fif- 
teen or  twenty  degrees  lower.  As  a  general  rule, 
for  persons  sixty-five  years  of  age  and  upward, 
the  temperature  of  the  bed-room  should  not  be 
below  60°,  and  when  there  are  any  symptoms 
of  bronchitis  it  should  be  raised  from  five  to  ten 
degrees  higher. 

Careful  cleansing  of  the  skin  is  the  last    point 
which  needs  to  be  mentioned  in  an  article  like 
132 


The   Art   of    Prolonging    Life 

the  present.  Attention  to  cleanliness  is  de- 
cidedly conducive  to  longevity,  and  we  may  con- 
gratulate ourselves  on  the  general  improvement 
in  our  habits  in  this  respect.  Frequent  washing 
with  warm  water  is  very  advantageous  for  old 
people,  in  whom  the  skin  is  only  too  apt  to  be- 
come hard  and  dry;  and  the  benefit  will  be  in- 
creased if  the  ablutions  be  succeeded  by  friction 
with  coarse  flannel  or  linen  gloves,  or  with  a 
flesh-brush.  Every  part  of  the  skin  should  be 
thus  washed  and  rubbed  daily.  The  friction 
removes  worn-out  particles  of  the  skin,  and  the 
exercise  promotes  warmth  and  excites  perspira- 
tion. Too  much  attention  can  hardly  be  paid 
to  the  state  of  the  skin;  the  comfort  of  the  aged 
is  greatly  dependent  upon  the  proper  discharge 
of  its  functions. 

Such,  then,  are  the  principal  measures  by 
which  life  may  be  prolonged  and  health  main- 
tained down  to  the  closing  scene.  /  It  remains 
to  be  seen  whether,  as  a  result  of  progress  of 
knowledge  and  civilization,  life  will  ever  be  pro- 
tracted beyond  the  limit  assigned  to  it  in  a  pre- 
ceding paragraph.  There  is  no  doubt  that  the 
average  duration  of  human  life  is  capable  of  very 
great  extension,  and  that  the  same  causes  which 
serve  to  prolong  life  materially  contribute  to- 
ward the  happiness  of  mankind.  The  experi- 
ence of  the  last  few  decades  abundantly  testifies 
to  the  marked  improvement  which  has  taken 
place  in  the  public  health.  Statistics  show 
that  at  the  end  of  the  septennial  period,  iSSi-'Sy, 
133 


Masterpieces   of   Science 

400,000  persons  Avere  alive  in  England  and  Wales 
whose  death  would  have  taken  place  had  the  mor- 
tality been  in  the  same  proportion  as  during  the 
previous  decade.  It  may  be  reasonably  ex- 
pected that  as  time  goes  on  there  will  be  an 
increase  in  the  proportion  of  centenarians  to  the 
population  as  a  whole. 

The  question  whether  long  life  is,  after  all, 
desirable  does  not  admit  of  any  general  answer. 
Much  depends  upon  the  previous  history  of  the 
individual,  and  his  bodily  and  mental  condition. 
The  last  stages  of  a  well  spent  life  may  be  the 
happiest,  the  shuffling-off  of  the  mortal  coil, 
though  calmly  expected,  need  not  be  wished 
for.  The  picture  afforded  by  cheerful  and 
mellow  old  age  is  a  lesson  to  younger  generations. 
Elderly  people  may,  if  they  choose,  become 
centers  of  improving  and  refining  influence. 
On  the  other  hand,  old  age  can  not  be  regarded 
as  a  blessing  when  it  is  accompanied  by  pro- 
found decrepitude  and  disorder  of  mind  and 
body.  Senile  dementia,  or  second  childishness, 
is,  of  all  conditions,  perhaps  the  most  miserable, 
though  not  so  painful  to  the  sufferer  as  to  those 
who  surround  him.  Its  advent  may  be  acceler- 
ated by  ignorance  and  neglect,  and  almost  as- 
suredly retarded  or  prevented  by  such  simple 
measures  as  have  been  suggested.  No  one  who 
has  had  opportunities  of  studying  old  people 
can  shut  his  eyes  to  the  fact  that  many  of  the 
incapabilities  of  age  may  be  prevented  by  at- 
tention to  a  few  simple  rules,  the  observance  of 
134 


The   Art   of    Prolonging    Life 

which  will  not  only  prolong  life  and  make  it 
happier  and  more  comfortable,  but  will  reduce 
to  a  minimum  the  period  of  decrepitude.  Old 
age  may  be  an  incurable  disease,  admitting  of 
but  one  termination,  but  the  manner  of  that 
end,  and  the  condition  which  precedes  it,  are, 
though  not  altogether,  certainly  to  a  very  great 
extent,  within  our  own  power. 


135 


NATURAL  LIFE  AND  DEATH:  AND 
RULES  FOR  HEALTH 

Benjamin   Ward  Richardson,  M.  D. 

[Dr.  Richardson  was  an  English  physician  of  uncommon 
originality  and  ability.  He  founded  and  for  some  years 
edited  the  Journal  of  Public  Health,  chiefly  directed  toward 
the  prevention  of  disease.  In  1875  he  created  widespread 
interest  by  sketching  an  imaginary  '* Model  City  of  Health" 
to  be  called  Hygeia.  He  wrote  several  important  books; 
from  "The  Diseases  of  Modern  Life,"  published  by  D.  Apple- 
ton  &  Co.,  New  York,  are  taken  the  extracts  which  follow.] 

By  the  strict  law  of  Nature  a  man  should  die 
as  -unconscious  of  his  death  as  of  his  birth. 

Subjected  at  birth  to  what  would  be,  in  the 
after-conscious  state,  an  ordeal  to  which  the  most 
cruel  of  deaths  were  not  possibly  more  severe,  he 
sleeps  through  the  process,  and  only  upon  the 
subsequent  awakening  feels  the  impressions,  pain- 
ful or  pleasant,  of  the  world  into  which  he  is 
delivered.  In  this  instance  the  perfect  law  is 
fulfilled  because  the  carrying  of  it  out  is  retained 
by  Nature  herself:  human  free-will  and  the  ca- 
price that  springs  from  it  have  no  influence. 

By  the  hand  of  Nature  death  were  equally  a 
painless  portion.  The  cycle  of  life  completed, 
the  living  being  sleeps  into  death  when  Nature 
has  her  way. 

This  purely  painless  process,  this  descent  by 
137 


Masterpieces   of  Science 

oblivious  trance  into  oblivion,  this  natural  phys- 
ical death,  is  the  true  Euthanasia;  and  it  is  the 
duty  of  those  we  call  physicians  to  secure  for 
man  such  good  health  as  shall  bear  him  in  activity 
and  happiness  onward  in  his  course  to  this  goal. 
For  Euthanasia,  though  it  be  open  to  every  one 
bom  of  every  race,  is  not  to  be  had  by  any  save 
through  obedience  to  those  laws  which  it  is  the 
mission  of  the  physician  to  learn,  to  teach,  and  to 
enforce.  Euthanasia  is  the  sequel  of  health, 
the  happy  death  engrafted  on  the  perfect  life. 

When  the  physician  has  taught  the  world  how 
this  benign  process  of  Nature  may  be  secured, 
and  the  world  has  accepted  the  lesson,  death  itself 
will  be  practically  banished;  it  wall  be  divested 
equally  of  fear,  of  sorrow,  of  suffering.  It  will 
come  as  a  sleep. 

If  you  ask  me  what  proof  there  is  of  the  pos- 
sibility of  such  a  consummation,  I  point  to  our 
knowledge  of  the  natural  phenomena  of  one  form 
of  dissolution  revealed  to  us  even  now  in  perfect, 
though  exceptional,  illustration.  We  have  all 
seen  Nature,  in  rare  instances,  vindicating  her- 
self despite  the  social  opposition  to  her,  and 
showing  how  tenderly,  how  soothingly,  how  like 
a  mother  with  her  foot  on  the  cradle,  she  would, 
if  she  were  permitted,  rock  us  all  gently  out  of 
the  world.  How,  if  the  free-will  with  which  she 
has  armed  us  were  brought  into  accord  with  her 
designs,  she  would  give  us  the  riches,  the  beauties, 
the  wonders  of  the  Universe  for  our  portion  so 
long  as  we  could  receive  and  enjoy  them;  and  at 
138 


Natural   Life   and   Death 

last  would  gently  withdraw  usfrom  them,  sense  by- 
sense,  with  such  imperception  that  the  pain  of  the 
withdrawal  would  be  tmfelt  and  indeed  unknown. 

Ten  times  in  my  own  observation  I  remember 
witnessing,  with  attentive  mind,  these  phenom- 
ena of  natural  Euthanasia.  Without  pain, 
anger,  or  sorrow,  the  intellectual  faculties  of  the 
fated  man  lose  their  brightness.  Ambition 
ceases,  or  sinks  into  desire  for  repose.  Idea  of 
time,  of  space,  of  duty,  lingeringly  pass  away. 
To  sleep  and  not  to  dream  is  the  pressing  and, 
step  by  step,  still  pressing  need;  until  at  length 
it  whiles  away  nearly  all  the  hours.  The  awaken- 
ings are  shorter  and  shorter;  painless,  careless, 
happy  awakenings  to  the  hum  of  a  busy  world, 
to  the  merry  sounds  of  children  at  play,  to  the 
sound  of  voices  offering  aid;  to  the  effort  of  talk- 
ing on  simple  topics  and  recalling  events  that  have 
dwelt  longest  on  the  memory ;  and  then  again  the 
overpowering  sleep.  Thus  on  and  on,  until  at 
length,  the  intellectual  nature  lost,  the  instinc- 
tive and  merely  animal  functions,  now  no  longer 
required  to  sustain  the  higher  faculties,  in  their 
turn  succumb  and  fall  into  inertia. 

This  is  death  by  Nature,  and  when  mankind 
has  learned  the  truth,  when  the  time  shall  come — 
as  come  it  will — that  "there  shall  be  no  more  an 
infant  of  days,  nor  an  old  man  who  hath  not 
filled  his  days, "  this  act  of  death,  now,  as  a  rule, 
so  dreaded  because  so  premature,  shall,  arriving 
only  at  its  appointed  hour,  suggest  no  terror,  in- 
flict no  agony. 

139 


Masterpieces   of   Science 

The  sharpness  of  death  removed  from  those 
who  die,  the  poignanc}-  of  grief  would  be  almost 
equally  removed  from  those  who  sunave,  were 
natural  Euthanasia  the  prevailing  fact.  Our 
sensibilities  are  governed  by  the  observance  of 
natural  law  and  the  breach  of  it.  It  is  only 
when  nature  is  vehemently  interrupted  that  we 
either  wonder  or  weep.  Thus  the  old  Greeks, 
fathers  of  true  mirth,  who  looked  upon  prolonged 
grief  as  an  offence,  and  attached  the  word  mad- 
ness to  melancholy, — even  they  were  so  far  im- 
bued with  sorrow  when  the  child  or  the  youth 
died,  that  they  bore  the  lifeless  body  to  the 
pyre  in  the  break  of  the  morning,  lest  the  sun 
should  behold  so  sad  a  sight  as  the  young  dead ; 
while  we,  who  court  rather  than  seek  to  dismiss 
melancholy,  who  find  poetr>^  and  piety  in  mel- 
ancholic reverie,  and  who  indulge  too  often  in 
what,  after  a  time,  becomes  the  luxury  of  woe,  ex- 
perience a  gradation  of  suffering  as  we  witness  the 
work  of  death.  For  the  loss  of  the  child  and  the 
youth  we  mourn  in  the  perfect  purity  of  sorrow; 
for  the  loss  of  the  man  in  his  activity  we  feel 
grief  mingled  wnth  selfish  regret  that  so  much  that 
was  useful  has  ceased  to  be.  In  the  loss  of  the 
aged,  in  their  days  of  second  childishness  and 
mere  oblivion,  we  sympathize  for  something 
that  has  passed  away,  and  for  a  moment 
recall  events  saddening  to  the  memory;  but 
how  soon  this  consoling  thought  succeeds  and 
conquers — that  the  race  of  the  life  that  has 
gone  was  run,  and  that  for  its  omti  sake  the 
140 


Natural   Life    and   Death 

dispensation   of  its  removal  was  most  merciful 
and  most  wise. 

To  the  rule  of  natural  death  there  are  a  few 
exceptions.  Unswerving  in  her  great  purpose 
for  the  universal  good,  Nature  has  imposed  on 
the  world  of  life  her  storms,  earthquakes,  light- 
nings, and  all  those  sublime  manifestations  of 
her  supreme  power  which,  in  the  infant  days  of 
the  universe,  cowed  the  boldest  and  implanted 
in  the  human  heart  fears  and  superstitions  which 
in  hereditary  progression  have  passed  down  even 
to  the  present  generations.  Thus  she  has  ex- 
posed us  all  to  accidents  of  premature  death, 
but,  with  infinite  wisdom,  and  as  if  to  tell  us  that 
her  design  is  to  provide  for  these  inevitable 
calamities,  she  has  given  a  preponderance  of 
number  at  birth  to  those  of  her  children  who  by 
reason  of  masculine  strength  and  courage  shall 
have  most  frequently  to  face  her  elements  of 
destruction.  Further,  she  has  provided  that 
death  by  her,  by  accidental  collision  with  herself 
shall,  from  its  very  quickness,  be  freed  of  pain. 
For  pain  is  a  product  of  time.  To  experience 
pain  the  impression  producing  it  must  be  trans- 
mitted from  the  injured  part  of  the  living  body 
to  the  conscious  centre,  must  be  received  at  the 
conscious  centre,  and  must  be  recognized  by  the 
mind  as  a  reception;  the  last  act  in  truth  being 
the  conscious  act.  In  the  great  majority  of 
deaths  from  natural  accidents  there  is  not  suffi- 
cient time  for  the  accomplishment  of  these  pro- 
gressive steps  by  which  the  consciousness  is 
141 


Masterpieces   of   Science 

reached.  The  unconsciousness  of  existence  is 
the  first  and  last  fact  inflicted  upon  the  stricken 
organism:  the  destruction  is  so  mighty,  that  the 
sense  of  it  is  not  revealed. 

The  duration  of  time  intended  by  Nature  to 
extend  between  the  birth  of  the  individual  and 
his  natural  Euthanasia  is  undetermined,  except 
in  an  approximate  degree.  From  the  first,  the 
steady,  stealthy  attraction  of  the  earth  is  ever 
telling  upon  the  living  body.  Some  force  lib- 
erated from  the  body  during  life  enables  it,  by 
self-controlled  resistance,  to  overcome  its  own 
weight.  For  a  given  part  of  its  cycle  the  force 
produced  is  so  efficient,  that  the  body  grows  as 
well  as  moves  by  its  agency  against  weight;  but 
this  special  stage  is  limited  to  an  extreme,  say,  of 
thirty  years.  There  is  then  another  period, 
limited  probably  also  to  thirty  years,  during 
which  the  living  structure  in  its  full  develop- 
ment maintains  its  resistance  to  its  weight. 
Finally,  there  comes  a  time  when  this  resistance 
begins  to  fail,  so  that  the  earth,  which  never  for 
a  moment  loses  her  grasp,  commences  and  con- 
tinues to  prevail,  and  after  a  struggle,  extended 
from  twenty  to  thirty  years,  conquers,  bringing 
the  exhausted  organism  which  has  daily  ap- 
proached nearer  and  nearer  to  her  dead  self,  into 
her  dead  bosom. 

Why  the  excess  of  power  developed  during 
growth  or  ascent  of  life  should  be  limited  as  to 
time;  why  the  power  that  maintains  the  de- 
veloped body  on  the  level  plain  should  be  limited 
142 


Rules    for    Health 

as  to  time ;  why  the  power  should  decline  so  that 
the  earth  should  be  allowed  to  prevail  and  bring 
descent  of  life,  are  problems  as  yet  unsolved. 
We  call  the  force  that  resists  the  earth  Vital. 
We  say  it  resists  death ;  we  speak  of  it  as  stronger 
in  the  young  than  in  the  old;  but  we  know  nothing 
more  of  it  really,  from  a  physical  point  of  view, 
than  that  while  it  exists  it  opposes  terrestrial 
weight  sufficiently  to  enable  the  body  to  move 
with  freedom  on  the  surface  of  the  earth. 

These  facts  we  accept  as  ultimate  facts.  To 
say  that  the  animal  is  at  birth  endowed  with 
some  reserve  force,  something  over  and  above 
what  it  obtains  from  food  and  air,  would  seem 
a  reasonable  conclusion;  but  we  have  no  proofs 
that  it  is  true,  save  that  the  young  resist  better 
than  the  old.  We  must  therefore  rest  content 
with  our  knowledge  in  its  simple  form,  gathering 
from  it  the  lesson  that  death,  a  part  of  the  scheme 
of  life,  is  ordained  upon  a  natural  term  of  life, 
is  beneficially  planned,  "is  rounded  with  a  sleep.  " 

[Then  follow  chapters  on  disease,  leading  up 
to  rules  for  health.] 

RULES    FOR    HEALTH 
I 

The  first  step  towards  the  reduction  of  disease 
is,  beginning  at  the  beginning,  to  provide  for  the 
health  of  the  unborn.  The  error,  commonly 
entertained,  that  marriageable  men  and  women 
have  nothing  to  consider  except  wealth,  station, 
or  social  relationships,  demands  correction.  The 
143 


Masterpieces   of   Science 

offspring  of  marriage,  the  most  precious  of  all 
fortunes,  deserv^es  surely  as  much  forethought 
as  is  bestowed  on  the  offspring  of  the  lower 
animals.  If  the  intermarriage  of  disease  were 
considered  in  the  same  light  as  the  intermarriage 
of  poverty,  the  hereditary^  transmission  of  disease, 
the  basis  of  so  much  misery  in  the  world, 
would  be  at  an  end  in  three  or  at  most  four 
generations. 

II 

Greater  care  than  is  at  present  manifested 
ought  to  be  taken  with  women  who  are  about  to 
become  mothers.  Wealthy  women  in  this  con- 
dition are  often  too  much  indulged  in  rest  and 
are  too  richly  fed.  Poor  women  in  this  condition 
are  commonly  underfed  and  made  to  toil  too 
severely.  The  poor,  as  we  have  seen,  fare  the 
best,  but  both,  practically,  are  badly  cared  for. 
Nothing  that  is  extraordinary  is  required  for  the 
woman  during  this  condition  named.  She 
needs  only  to  live  by  natural  rule.  She  should 
retire  to  rest  early;  take  nine  hours'  sleep;  per- 
form walking  or  similar  exercise,  to  an  extent 
short  of  actual  fatigue,  during  the  day;  partake 
moderately  of  food,  and  of  animal  food  not  of- 
tener  than  twice  in  the  day;  avoid  all  alcoholic 
drinks;  take  tea  in  limited  quantities;  forego  all 
scenes  that  excite  the  passions ;  hear  no  \'iolence 
of  languages,  be  clothed  in  warm,  light,  loose 
garments;  and  shtm,  with  scrupulous  care,  every 
exposure  to  infectious  disease. 
144 


Rules    for   Health 


III 


In  meeting  the  uncontrollable  causes  of  disease 
the  special  influence  of  season  deserves  particular 
regard.  It  should  always  be  remembered  that, 
other  things  being  equal,  during  winter  the  body 
loses,  during  summer  gains  in  weight.  Further, 
it  should  be  remembered  that  these  changes  are 
abrupt:  that  usually  the  loss  commences,  sharply, 
in  September  and  lasts  until  April,  and  that 
the  gain  commences  in  April  and  lasts  until 
September.  In  September,  though  the  weather 
even  be  warm,  it  is  right,  therefore,  to  add  to  the 
clothing  and  to  commence  a  little  excess  of  food. 
In  summer  it  is  right  not  only  to  reduce  the 
clothing,  but  to  eat  less  food  than  in  winter. 

IV 

The  best  means  of  preventing  the  spread  of  the 
communicable  diseases  is  perfect  and  instant 
isolation  of  the  affected,  and  removal  and  thor- 
ough purifying  of  all  clothing  and  bedding  with 
which  the  affected  have  come  in  contact.  It  is 
a  vulgar  error  to  suppose  that  every  child  must 
necessarily  suffer  from  the  contagious  maladies, 
and  that  the  risk  of  exposure  to  infection  is, 
therefore,  of  little  moment.  The  chance  of  in- 
fection lessens  with  advance  of  life,  and  that  per- 
son is  strongest  who  has  never  passed  through 
a  contagious  malady.  Against  small-pox  vaccina- 
tion is  the  grand  safeguard,  but  even  vaccination 
ought  never  to  prevent  the  isolation  of  those  who 
suffer  from  small-pox. 

145 


Masterpieces   of   Science 
V 

The  mortality  from  the  uncontrollable  causes 
of  disease  amongst  persons  of  advanced  life  is 
best  prevented  by  proN-iding  against  sudden 
vicissitudes  of  heat  and  cold.  The  primary  care 
is  to  guard  against  sudden  change  of  vascular 
tension  from  exposure  to  heat  when  the  blood- 
vessels are  weakened  by  cold.  Such  exposure 
is  the  cause  of  nearly  all  the  congestions  which 
occur  during  winter,  and  which  carry  off  the 
enfeebled.  The  sound  practice  is  to  maintain 
the  body,  at  all  hours  and  seasons,  but  especially 
during  the  hours  of  sleep,  at  an  equable  tem- 
perature. The  temperature  of  60°  Fah.  may  be 
considered  a  safe  standard. 

VI 

The  true  danger  of  ever}-  form  of  mental 
exercise  is  the  addition  of  worry.  Laborious 
mental  exercise  is  healthy  unless  it  be  made 
anxious  by  necessary'  or  unnecessary  difficulties. 
Regular  mental  labour  is  best  carried  on  by  intro- 
ducing into  it  some  variety.  New  work  gives 
time  for  repair  better  than  attempt  at  complete 
rest,  since  the  active  mind  finds  it  impossible  to 
evade  its  particular  work  unless  its  activity  be 
diverted  into  some  new  channel.  During  the 
new  work  a  fresh  portion  of  the  brain  comes  into 
play  and  the  overvNTOught  seat  of  mental  faculty 
is  secured  repose  and  recover^".  Excessive  com- 
petition in  mental  labour  is  ruinous  at  all  ages  of 
Ufe. 

146 


Riiles   for   Health 

VII 

The  idea  that  excessive  physical  exercise  is  a 
sound  means  of  promoting  health  is  erroneous. 
Man  is  not  constructed  to  be  a  running  or  a  leap- 
ing animal  like  a  deer  or  a  cat,  and  to  raise  the 
physical  above  the  mental  culture  were  to  return 
to  the  shortness  and  misery  of  savage  life.  Phy- 
sical training,  while  it  should  be  moderately  en- 
couraged, should  be  refined  and  made  secondary 
to  mental  training.  Every  rash  and  violent  feat 
of  competitive  prowess  should  be  discounte- 
nanced. 

VIII 

The  combination  of  mental  and  physical 
fatigue,  as  it  is  practised  in  many  pursuits  at 
this  time,  are  exceedingly  dangerous.  Long 
journeys  each  day,  to  and  from  the  sphere  of 
profession  or  business,  are  hurtful.  The  idea  that 
mental  labour  may  be  advantageously  supple- 
mented by  violent  muscular  exercise,  such  as 
is  implied  in  long  and  fatiguing  walks  or  labori- 
ous exercise  on  horseback,  is  an  error.  Moderate 
and  regular  exercise,  at  the  same  time,  favours 
mental  work.  The  practical  point  is  to  regulate 
the  physical  labour  that  it  shall  not  induce 
fatigue. 

IX 

One  of  the  surest  means  for  keeping  the  body 
and  mind  in  perfect  health  consists  in  learning 
to  hold  the  passions  in  subservience  to  the  reason- 
147 


Masterpieces   of   Science 

ing  faculties.  This  rule  applies  to  every  passion. 
Man,  distinguished  from  all  other  animals  by 
the  peculiarity  of  his  reason,  is  placed  above  his 
passions  to  be  the  director  of  his  will,  can  protect 
himself  from  every  mere  animal  degradation  re- 
sulting from  passionate  excitement.  The  educa- 
tion of  the  man  should  be  directed,  not  to  sup- 
press such  passions  as  are  ennobling,  but  to 
bring  under  governance,  and  especially  to  subdue, 
those  most  destructive  passions,  anger,  hate, 
and  fear. 

X 

To  escape  the  evils  arising  from  the  use  of 
alcohol  there  is  only  one  perfect  cotirse,  namely, 
to  abstain  from  alcohol  altogether.  No  fear 
need  be  entertained  of  any  physical  or  mental 
harm  from  such  abstinence.  Every  good  may 
be  expected  from  it.  True,  a  certain  very  quali- 
fied temperance,  a  temperance  that  keeps  the 
adult  to  a  strict  allowance  of  one  ounce  and  a 
half  of  alcohol  in  each  twenty-four  hours,  may 
possibly  be  Qompatible  with  a  healthy  life;  but 
such  indulgence  is  unnecessary  and  encourages 
the  dangerous  desire  to  further  indulgence.  A 
man  or  woman  who  abstains  is  healthy  and  safe. 
A  man  or  woman  who  indulges  at  all  is  unsafe. 
A  man  or  woman  who  relies  on  alcohol  for  sup- 
port is  lost. 

XI 

Smoking  tobacco,  and  the  use  of  tobacco  in 
every  form,  is  a  habit  better  not  acquired,  and 
148 


Rules    for   Health 

when  acquired  is  better  abandoned.  The  young 
should  especially  avoid  the  habit.  It  gives  a 
doubtful  pleasure  for  a  certain  penalty.  Less 
destructive  than  alcohol,  it  induces  various  nerv- 
ous changes,  some  of  which  pass  into  organic 
modifications  of  function.  So  long  as  the  prac- 
tice of  smoking  is  continued  the  smoker  is  tem- 
porarily out  of  health.  When  the  odour  of 
tobacco  hangs  long  on  the  breath  and  other  secre- 
tions of  the  smoker,  that  smoker  is  in  danger. 
Excessive  smoking  has  proved  directly  fatal. 

XII 

Indulgence  in  narcotics,  opium,  chloral,  chloro- 
dyne,  ether,  absinthe,  and  all  others  of  the  class, 
is  an  entire  departure  from  natural  law.  Except 
under  the  direction  of  skilled  opinion  and  for  the 
cure  of  disease,  the  use  of  these  agents  is  subver- 
sive of  the  animal  functions,  and  is  a  certain 
means  of  embittering  and  shortening  life.  It  is 
doubtful  whether  the  freedom  of  the  subject 
ought  to  be  permitted  to  extend  to  the  uncon- 
trolled self-indulgence  in  these  poisons.  The 
indulgence  indicates  an  unsound  reason  which  re- 
quires to  be  governed  by  sound  reason,  temper- 
ately enforced. 

XIII 

The  food  on  which  the  man  who  would  be 

healthy  should    live  should  be  selected  so  as  to 

ensure    variety    without    excess.     Animal    food 

should  not  be  taken  oftener  than  twice  daily. 

149 


Masterpieces   of  Science 

The  amount  of  animal  and  vegetable  food  com- 
bined should  not  exceed  thirty  ounces  in  the 
twenty-four  hours,  and  for  the  majority  of  per- 
sons an  average  of  twenty-four  ounces  of  mixed 
solid  food,  a  third  only  of  which  should  be  animal, 
is  sufficient.  All  animal  foods  should  be  eaten 
while  they  are  fresh  and  after  they  are  well 
cooked.  The  habit  of  eating  underdone  flesh 
is  an  almost  certain  cause  of  parasitic  disease. 
The  amount  of  fluid  taken,  in  any  form,  should 
not  exceed  an  average  of  twenty-four  ounces 
daily.     Water  is  the  only  natural  beverage. 

XIV 

To  escape  the  injuries  arising  from  impure  air 
it  is  necessary  to  attend  to  the  following  rules: 
To  avoid  the  admission  into  closed  apartments 
of  air  charged  ^nth  any  substance  that  offends  the 
sense  of  smell.  To  avoid  surcharging  the  air 
with  vapour  of  water.  To  keep  the  temperature 
in  ever}'  room  as  nearly  as  possible  at  the  safe 
standard  of  60°  Fah.  To  take  ample  means  of 
allowing  air  to  escape  from  the  room  by  every 
av^ailable  outward  draught,  by  the  chimney  flue 
especially.  To  admit  air  freely  at  all  times,  and, 
when  a  room  is  not  in  use  and  the  external  air  is 
not  charged  with  moisture,  to  allow  the  entrance 
of  air  from  without  through  every  window  and 
door. 

XV 

Occupations  of  every  kind,   however  varied 
they  may  be,  require  to  be  alternated,  fairly,  -wnth 
150 


Rules  for  Health 

rest  and  recreation.  It  is  the  worst  mistake  to 
suppose  that  most  and  best  work  can  be  done 
when  these  aids  are  omitted.  Strictly,  no  occu- 
pation that  calls  forth  special  mental  and  physical 
work  should  fill  more  than  one-third  of  the  daily 
life.  The  minds  of  men  of  all  classes  ought  now 
to  be  devoted  to  the  promotion  of  a  systematic 
method  by  which  the  productive  labour  of  every 
life  should  be  carried  on  within  the  limited  term 
of  eight  hours  in  the  twenty-four.  The  body  of 
man  is  not  constructed  to  run  its  completed  circle 
under  a  heavier  burden  of  labour. 

XVI 

Enforced  idleness,  by  those  who  have  acquired 
wealth,  is  always  an  error  so  long  as  the  health 
is  good.  Men  of  business  should  never  actually 
retire  while  they  retain  fair  bodily  and  physical 
faculty.  It  is  one  of  the  gravest  of  errors  to 
attempt  to  enforce  idleness  on  others  from  the 
mistaken  sentiment  of  wishing  to  place  them 
beyond  the  necessity  for  work.  This  is  against 
nature.  The  earth,  which  is  itself  ever  in  motion, 
demands  ever  the  motion  of  cultivation  from 
its  inhabitants  that  it  may  be  a  garden  properly 
arranged  from  age  to  age.  Those,  therefore,  who 
have  idleness  thrust  upon  them,  by  their  pro- 
genitors, should  throw  it  off  as  if  some  necessity 
for  work  were  equally  theirs.  By  this  plan  they 
will  live  longest  to  enjoy  the  greatest  hap- 
piness. 

151 


Masterpieces   of   Science 

XVII 

The  natural  duration  of  sleep  is  eight  hours 
out  of  the  twenty-four,  and  those  who  can  secure 
this  lead  the  soiindest  lives.  It  is  best  taken 
from  ten  o'clock  till  six,  and  it  is  most  readily 
obtained  by  cultivating  it  as  an  automatic  pro- 
cedure. All  stimulants,  all  excitements,  all  ex- 
cessive fatigues,  all  exhaustions  pervert  sleep 
even  if  they  do  not  prevent  it.  The  room  in 
which  sleep  is  taken  should  be  the  best  ventilated 
and  the  most  equably  warmed  room  in  the  house. 
The  air  of  the  room  should  be  maintained  at  the 
natural  standard  of  60°  Fah.,  and  the  body  of  the 
sleeper  should  always  be  kept  completely  warm. 
The  bed  should  be  soft  and  yielding.  A  regular 
tendency  to  sleep  at  other  hours  than  the  natiu-al 
is  a  sure  sign  of  error  of  habit  or  of  nervous  de- 
rangement. 

XVIII 

Dress,  to  be  perfectly  compatible  vrith.  healthy 
life,  should  fit  loosely,  should  be  light,  warm,  and 
porous,  shotdd  be  adapted  to  the  season  as  to 
colour,  should  be  throughout  every  part  of  the 
clothing,  upper  as  well  as  under,  frequently 
changed,  and  should  be,  at  all  times,  scrupulously 
clean.  The  wearing  of  clothes  until  they  are 
threadbare,  is  an  invariable  error  in  all  that 
respects  the  health,  to  say  nothing  of  the  com- 
fort of  the  wearer.  All  bands  or  corsets  which 
in  any  way  restrict  the  course  of  the  blood  in 
any  part  of  the  body  are  directly  injurious. 
152 


Rules  for  Health 

Dresses  dyed  with  irritating  dyestuffs  ought  to 
be  carefully  avoided. 

XIX 

Connected  with  cleanliness  of  clothing,  as  a 
means  of  health,  is  personal  cleanliness.  Per- 
fected action  of  the  skin,  so  essential  to  the  per- 
fect life,  can  only  be  obtained  by  thorough  ablu- 
tion of  the  whole  body.  The  ablution  ought, 
strictly,  to  be  performed  once  in  every  twenty- 
four  hours.  It  is  best  to  train  the  body  to  the  use 
of  cold  water  through  all  seasons,  so  that  the 
requirement  for  water  of  raised  temperature 
may  not  become  a  necessity.  The  simplest  and 
best  bath  is  the  ordinary  sponge-bath.  Plung- 
ings,  splashings,  showers,  and  the  like  are  mere 
pastimes.  The  occasional  use  of  the  hot  air 
or  Turkish  bath  is  an  important  adjunct  to  the 
means  of  maintaining  health. 


153 


CARE    OF   THE    EYES 

BUEL.    P.    COLTON 

["Physiology,  Experimental  and  Descriptive,"  by  Buel 
P  Colton,  Professor  of  Natural  Science  in  the  Illinois  State 
Normal  University,  is  a  capital  text-book  which  may  be  read 
as  gainfully  at  home  as  in  school  or  at  college.  Throughout 
its  chapters  are  excellent  directions  for  the  care  of  health  and 
strength.  It  is  pubhshed  by  D.  C.  Heath  &  Co  .  Boston 
1898  The  following  extract  was  revised  by  Dr.  Casey  A 
Wood,  an  eminent  oculist  of  Chicago  0 

In  reading  we  wish  light  from  the  printed 
page.  Hence  we  should  avoid  light  entering 
the  eye  from  any  other  source  at  this  time.  While 
reading,  then,  do  not  face  a  window,  another 
light,  a  mirror,  or  white  wall,  if  it  can  be  avoided. 
In  a  room,  white  walls  are  likely  to  injure  the 
eyes.  Choose  a  dark  colour  for  a  covering  for  a 
reading  table.  Sewing  against  the  background 
of  a  white  apron  has  worked  serious  mischief. 
Direct  sunshine  near  the  book  or  on  the  table  is 
likely  to  do  harm. 

Preferably  have  the  light  from  behind  and 
above.  Many  authors,  say  "from  the  left"  or 
"over  the  left  shoulder."  In  writing  with  the 
usual  slant  of  the  letters  this  may  be  desirable. 
But  vertical  writing  is  now  strongly  advocated,  as 
it  enables  one  to  sit  erect,  and  have  the  light 
from  above  and  equally  to  the  two  eyes.  Hav- 
155 


Masterpieces   of  Science 

ing  stronger  light  for  one  eye  than  for  the  other 
is  bad.  Sitting  under  and  a  little  forward  of  a 
hanging  lamp  will  give  the  light  equally  to  the 
two  eyes  and  send  no  light  direct  into  the  face. 
In  reading  by  daylight  avoid  cross-lights  as 
much  as  possible.  The  incandescent  electric 
light  has  an  advantage  in  being  readily  lighted 
without  matches,  and  in  gi\nng  out  little  heat, 
thus  making  it  valuable  for  house-lighting;  but 
owing  to  its  irregular  illumination  (due  to  the 
shadow  cast  by  the  wire  or  filament),  it  is  not 
well  suited  for  study  or  other  near  work.  For 
this  purpose  an  Argand  gas  or  kerosene  burner 
is  much  to  be  preferred,  since  it  throws  a  soft, 
uniform,  and  agreeable  light  upon  the  work. 

Reading  out-of-doors  is  likely  to  injure  the 
eyes,  especially  when  lying  down.  To  try  to 
read  while  lying  in  a  hammock  is  bad  in  many 
ways.  Too  much  light  directly  enters  the  eye, 
and  often  too  little  falls  upon  the  printed  page. 

Do  not  hold  the  book  or  work  nearer  the  eyes 
than  is  necessary.  So  far  as  possible  avoid  con- 
tinuous reading  in  large  or  hea\'y  books  by 
artificial  light.  Such  books  being  hard  to  hold, 
the  elbows  gradually  settle  down  against  the 
sides  of  the  body,  and  thus,  without  thinking 
about  it,  the  book  is  held  too  close  to  the  eyes,  or 
at  a  bad  angle,  or  the  body  assumes  a  bad  posi- 
tion. 

Frequently  rest  the  eyes  by  looking  up  and 
away  from  the  work,  especially  at  some  distant 
object.  One  may  rest  the  eyes  while  thinking 
156 


Care   of   the   Eyes 

over  each  page  or  paragraph,  and  thus  really  gain 
time  instead  of  losing  it. 

Have  light  that  is  strong  enough.  Remember 
that  the  law  of  the  intensity  of  light  as  affected 
by  distance  is  that  at  twice  the  distance  from  the 
source  of  light  the  light  is  only  one-fourth  as 
strong.  Reading  just  before  sunset  is  risky. 
One  is  tempted  to  go  on,  not  noticing  the  gradual 
diminution  of  light. 

Save  the  easiest  reading  for  the  evening. 
Newspapers,  as  a  rule,  have  neither  good  print 
nor  good  paper.  If  the  eyes  have  much  work  to 
do,  finish  this  kind  of  reading  by  daylight  if 
possible,  and  by  artificial  light  read  books,  which 
usually  have  better  type  and  better  paper. 

In  all  ways  endeavour  to  favour  the  eyes  by 
doing  the  most  difficult  reading  by  daylight,  and 
saving  the  better  print  and  the  books  that  are 
easier  to  hold  for  work  by  artificial  light.  Writ- 
ing is  usually  much  more  trying  to  the  eyes  than 
reading.  By  carefully  planning  his  work  the 
student  may  economize  eyesight,  and  it  is  desir- 
able that  persons  blessed  with  good  eyes  should 
be  careful,  as  well  as  those  who  have  a  natural 
weakness  in  the  eyes;  for  it  often  results  that 
those  inheriting  weak  organs,  by  taking  proper 
care,  may  outlast  and  do  more  and  better  work 
than  those  naturally  stronger,  but  who  through 
carelessness  injure  organs  by  improper  use  or 
wrong  use. 

Reading  before  breakfast  by  artificial  light  is 
usually  bad. 

157 


Masterpieces   of  Science 

Many  eyes  are  ruined  during  convalescence. 
At  this  time  the  whole  system  is  often  weak,  in- 
cluding the  eyes.  Still,  there  is  a  strong  tempta- 
tion to  read,  perhaps  to  while  away  the  time, 
perhaps  to  make  up  for  lost  time  in  school  work. 
This  is  a  time  when  a  friend  may  show  his  friend- 
ship by  reading  aloud  to  the  convalescent. 

If  one  finds  himself  rubbing  his  eyes,  it  is  a 
clear  sign  that  they  are  irritated.  It  may  be 
time  to  stop  reading.  At  any  rate,  one  should 
find  the  cause,  and  not  proceed  with  the  work 
imtil  the  irritation  ceases.  If  any  foreign  object 
gets  into  the  eye,  as  a  cinder,  it  is  better  not  to 
rub  the  eye,  but  to  draw  the  lid  away  from  the 
eyeball  and  wink  repeatedly;  the  increased  flow 
of  tears  may  dissolve  and  wash  the  matter  out. 
If  you  must  rub,  rub  the  other  eye.  If  it  be  a 
sharp-cornered  cinder,  rubbing  may  merely  serve 
to  fix  it  more  firmly  in  the  cornea  or  the  mucous 
membrane  of  the  inner  siirface  of  the  eyelid.  If 
it  does  not  soon  come  out,  the  lid  may  be  rolled 
over  a  pencil,  taking  hold  of  the  lashes  or  the 
edge  of  the  lid.  The  point  of  a  blunt  lead  pencil 
is  a  convenient  and  safe  instrument  with  which 
to  remove  the  particle.  Sometimes  being  out 
in  the  wind  (especially  if  unused  to  it) ,  together 
with  bright  sunlight,  may  irritate  the  eyes.  If 
after  such  exposure  one  finds  lamplight  irritating, 
he  \snll  do  well  to  go  to  bed  early,  or  to  remain  in 
a  dark  room. 

Be  careful  to  keep  the  eyes  clean.  Do  not 
rub  the  eyes  with  the  fingers.  Aside  from  con- 
158 


Care   of   the    Eyes 

siderations  of  etiquette,  there  is  danger  of  intro- 
ducing foreign  matter  that  may  be  harmful.  It 
is  very  desirable  that  each  person  have  his  indi- 
vidual face  towel.  By  not  observing  this  rule, 
certain  contagious  diseases  of  the  eye  often 
spread  rapidly. 

If  there  is  any  continuous  trouble  with  the 
eyes,  consult  a  reliable  oculist.  Many  persons 
injure  the  eyes  by  not  wearing  suitable  glasses. 
On  the  other  hand,  do  not  buy  glasses  of  peddlers 
or  of  any  but  reliable  specialists.  One  may 
ruin  the  eyes  by  wearing  glasses  when  they  are 
not  needed.     Sight  is  priceless. 


THE    PROGRESS   OF   MEDICINE    IN   THE 
NINETEENTH    CENTURY 

John   Shaw  Billings,  M.  D. 

[Dr.  Billings  is  a  surgeon  and  administrator  of  the  first 
rank.  He  is  now  a  director  of  the  New  York  Public  Library. 
Among  his  many  published  works  are  "Principles  of  Ventila- 
tion and  Heating,"  issued  by  the  Engineering  Record,  New 
York.  The  essay  which  follows  appeared  in  the  Evening 
Post,  New  York.  January  12,  1901,  copyrighted.  It  is  re- 
printed in  a  volume  entitled  "The  Nineteenth  Century:  a 
Review  of  Progress  During  the  Past  One  Hundred  Years," 
published  by  G.  P.  Putnam's  Sons,  New  York.  1901,  copy- 
righted. It  is  presented  here  by  the  kind  permission  of  Dr. 
Billings,  the  publisher  of  the  Evening  Post,  and  G.  P.  Put- 
nam's Sons.fl 

The  word  "medicine,"  as  used  in  the  title 
of  this  paper,  includes  all  branches  of  the  art 
of  prevention  and  treatment  of  disease  and 
injuries;  all  discoveries  of  methods  of  di- 
minishing physical  pain  and  of  prolonging 
life,  and  also  that  part  of  modem  science  which 
is  concerned  with  accurate  knowledge  of  the 
structure  and  functions,  normal  and  abnormal, 
of  the  human  body,  and  of  the  causes  of  diseases. 
In  other  words,  it  includes  not  only  therapeutics, 
medical  and  surgical,  but  also  physiology,  path- 
ology, and  hygiene. 

In  all  these  branches  of  medicine  greater  pro- 
gress has  been  made  during  the  last  century  than 
had  been  made  during  the  preuious  two  thousand 
161 


^lasterpieces   of  Science 

years.  This  progress  has  been  largely  due  to  im- 
provements in  methods  of  investigation  and 
diagnosis,  resulting  from  increase  of  knowledge 
in  chemistry  and  physics;  to  better  microscopes 
and  new  instruments  of  precision;  to  experi- 
mental work  in  laboratories  and  to  the  applica- 
tion of  scientific  method  and  system  in  the  ob- 
ser\'ation  and  recording  of  cases  of  disease  and 
of  the  results  of  different  modes  of  treatment. 
The  introduction  of  statistical  methods  in  the 
study  of  cases  of  disease  and  of  causes  of  death; 
the  discover}'-  of  general  anaesthetics;  the  adop- 
tion of  antiseptic  [excluding  microbes]  and  aseptic 
[uninfective]  methods  in  surgery,  and  the  devel- 
opment of  modem  bacteriology^ — each  marks  a 
point  in  the  histon."  of  medicine  in  the  nineteenth 
century. 

The  scientific  demonstration  that  some  dis- 
eases are  due  to  the  growth  and  development  of 
certain  specific  micro-organisms  in  the  human 
body  dates  from  about  twenty  years  ago,  al- 
though the  theory  of  such  causal  relation  is 
much  older.  Since  1880  it  has  been  proved  that 
anthrax.  Asiatic  cholera,  cerebro-spinal  menin- 
gitis, diphtheria,  one  form  of  dysentery,  ery- 
sipelas, glanders,  gonorrhoea,  influenza,  certain 
epidemics  of  meat-poisoning,  pyaemia  and  sup- 
puration in  general,  pneumonia,  tetanus,  re- 
lapsing fever,  tuberculosis,  bubonic  plague, 
and  typhoid  fever  are  due  to  minute  vegetable 
organisms  known  as  bacteria;  that  malarial 
fevers,  Texas  cattle  fever,  and  certain  forms  of 
162 


The   Progress   of  Medicine 

dysentery  are  due  to  forms  of  microscopic  ani- 
mal organisms  known  as  microzoa;  and  for  most 
of  these  diseases  the  mode  of  development  and 
means  of  introduction  of  the  micro-organism 
into  the  body  are  fairly  well  understood.  To 
the  information  thus  obtained  we  owe  the  tri- 
umphs of  antiseptic  and  aseptic  surgery,  a  great 
increase  of  precision  in  diagnosis,  the  use  of 
specific  antitoxins  [antidotes  to  organic  infection] 
as  remedies  and  as  preventives,  and  some  of  the 
best  practical  work  in  public  hygiene. 

The  evidence  as  to  the  increased  powers  of 
medicine  to  give  relief  from  suffering  and  to  pro- 
long life  is  most  clear  and  direct  in  the  records  of 
modem  surgery — particularly  in  some  of  its 
special  branches.  In  a  large  proportion  of  cer- 
tain cases  in  which  the  surgeon  now  operates 
with  a  fair  chance  of  success,  such  as  calculus  in 
the  kidney  or  gall-bladder,  shot-wounds  of  the 
abdomen,  and  tumours  of  various  kinds,  there 
was  no  hope  in  the  year  1800,  and  the  unhappy 
sufferer  could  only  expect  a  certain,  though 
often  a  lingering  and  painful,  death.  In  cases 
of  cancer  of  the  face,  tongue,  breast,  or  uterus, 
the  persistent  pain,  extreme  disfigurement,  and 
offensive  odors  which  attended  them  made 
death  a  boon  to  be  prayed  for,  if  not  deliberately 
sought,  while  now  such  cases,  if  brought  in  time 
to  the  surgeon,  can  often  be  entirely  relieved. 
The  knowledge  of  this  fact  has  become  general 
with  the  public,  and  patients  no  longer  defer  an 
operation  as  long  as  possible,  as  was  their  custom 
163 


Masterpieces   of   Science 

in  days  of  old.  Instead  of  having  to  look  for- 
ward to  the  torture  of  incisions,  manipulations, 
and  stitching,  with  but  small  hope  of  survi\'ing 
the  exhausting  suppuration  and  blood-poison- 
ing which  were  such  common  results,  the  patient 
now  knows  that  he  w^ll  inhale  a  little  sweet 
vapour,  and  sleep  unconscious  of  the  strokes  of 
the  surgeon's  knife  or  the  pricks  of  his  needle. 
He  may  dream  wondrous  dreams,  but  he  will 
soon  awake  to  find  himself  in  his  bed  staring  at 
the  trained  nurse  standing  by  his  side,  and 
wondering  vaguely  why  the  operation  has  not 
begun.  He  does  not  have  to  look  forward  to 
weeks  and  even  months  of  daily  dressings.  The 
surgeon  will  glance  at  his  temperature  record 
and  at  the  outside  of  his  bandages,  but  will 
probably  not  touch  them  for  a  week;  and  when 
he  does  remove  them  nothing  will  be  seen  but 
a  narrow  red  line  without  a  trace  of  suppuration. 
These  improved  methods  not  only  preserve  the 
mother  for  her  children,  and  the  bread-winner 
for  the  family,  but  they  greatly  contribute  to  the 
public  good  by  shortening  the  period  of  en- 
forced idleness  and  unproductivity  after  opera- 
tions. 

Some  of  the  greatest  triumphs  of  modem 
surgery  are  obtained  in  cases  of  disease  or  in- 
jury of  the  abdominal  organs.  The  removal 
of  ovarian  and  uterine  tumours  is  now  so  com- 
mon and  successful  that  it  is  not  easy  to  realize 
that  a  hundred  years  ago  there  was  practically 
no  help  or  hope  for  such  cases.  In  former  days, 
164 


The   Progress   of  Medicine 

the  lists  of  deaths  contained  many  cases  reported 
as  inflammation  or  obstruction  of  the  bowels, 
or  as  peritonitis.  It  is  now  well  understood  that 
most  of  these  cases  are  due  to  disease  of  a  little 
worm-like  appendix  connected  with  the  large 
intestine  on  the  right  side  of  the  lower  part  of  the 
abdomen,  inflammation  of  which,  known  as 
appendicitis,  causes  excruciating  pain,  and  often 
produces  internal  abscesses  and  death.  An 
operation  for  the  removal  of  such  a  diseased 
appendix  is  now  common,  and  in  most  cases 
successful.  The  operation  for  the  removal  of 
calculus,  or  stone,  from  the  urinary  bladder 
dates  from  over  twenty-five  hundred  years 
ago,  and  no  one  knows  who  first  performed  it. 
Within  the  last  century  it  has  been  largely 
superseded  by  an  operation  which  crushes  the 
stone  to  powder  within  the  bladder,  and  re- 
moves this  powder  without  the  use  of  the  knife. 
The  removal  of  calculi  from  the  kidney  or  from 
the  gall  bladder,  and  the  removal  of  a  diseased 
kidney,  are  new  operations,  made  possible  by 
improved  means  of  diagnosis,  anaesthesia,  and 
antisepsis  [determining  disease,  causing  in- 
sensibility, and  excluding  microbes].  Wounds 
of  the  intestines  were  formerly  thought  to  be 
almost  necessarily  fatal,  and  nothing  was  done 
for  them  except  to  stupify  the  patient 
with  opium.  Now  in  such  cases  the  abdomen 
is  opened,  the  lacerations  of  the  bowel  are  closed, 
the  effused  blood  and  other  matters  are  removed, 
and  in  many  cases  life  has  thus  been  preserved. 
165 


Masterpieces   of   Science 

By  increase  of  knowledge  of  the  anatomy 
of  the  brain,  and  of  the  distribution  of  ner\'es 
connected  with  it.  it  has  become  possible  in  a 
certain  number  of  cases  to  determine  what 
part  of  the  brain  is  suffering  from  irritation 
or  pressure,  and  to  operate  for  the  removal 
of  the  tumour  or  other  substance  causing  the 
trouble,  with  considerable  hope  of  giving  per- 
manent relief.  A  branch  of  surgery  which  has 
developed  into  an  important  specialty  during 
the  last  century  is  that  known  as  plastic  and 
orthopaedic  surgery  [ameliorating  deformities]. 
The  replacing  of  a  lost  nose  by  engrafting  other 
tissue  in  its  place  is  a  ver\^  old  triumph  of  sur- 
gical art,  but  operations  of  this  kind  have  been 
greatly  extended  and  perfected  within  the  last 
hundred  years,  and  much  can  now  be  done 
to  mitigate  the  deformity  and  weakness  due 
to  club  feet,  bandy  legs,  contracted  joints,  etc., 
which  formerly  were  considered  to  be  beyond 
remedy. 

Many  of  the  diseases  peculiar  to  women  have 
been  deprived  of  much  of  their  terrors  within  a 
hundred  years.  In  1800,  for  every  thousand 
children  bom,  from  ten  to  twenty  mothers 
died.  Puerperal  fever  occurred  in  epidemics, 
following  certain  physicians  and  nurses,  but 
nothing  was  known  as  to  its  causes  or  nature. 
To-day  puerperal  fever  is  almost  unkno\\Ti  in 
*ae  hospitals  or  in  the  practice  of  a  skilled 
physician.  The  death-rate  of  mothers  is 
less  than  five  per  thousand  births,  and  the 
166 


The   Progress   of   Medicine 

mechanical  obstructions  which  a  century  ago 
would  almost  certainly  have  brought  about 
the  death  of  both  mother  and  child,  are  now 
so  dealt  with  that  more  than  half  of  both  mothers 
and   children   are   saved. 

The  study  of  the  diseases  of  the  eye  has  greatly 
developed  another  specialty  during  the  centurv', 
viz.,  ophthalmology.  The  investigations  of 
Helmholtz  in  physiological  optics,  with  his 
invention  of  the  ophthalmoscope  in  1852, 
effected  a  revolution  in  this  branch  of  medical 
science  and  art,  and  have  added  greatly  to 
human  comfort  and  happiness.  A  hundred 
years  ago,  when  the  physician  saw  the  eyelids 
of  a  new-bom  babe  redden  and  swell,  and  yellow 
matter  ooze  from  between  them,  he  knew  that 
in  a  few  days  or  weeks  the  child  would  be  par- 
tially or  wholly  blind,  but  he  knew  nothing 
of  the  simple  means  by  which  the  skilled  phy- 
sician can  now  prevent  such  a  calamity.  It 
is  unfortunately  true  that  this  knowledge  is 
not  even  now  sufficiently  widely  diffused,  and 
that  our  blind  as3'lums  must,  for  some  time 
to  come,  continue  to  receive  those  that  have 
been  deprived  of  sight  during  the  first  months 
of  their  life  through  the  ignorance  or  neglect 
of  those  who  should  have  properly  cared  for 
them. 

While  it  is  certain  that  the  death-rates  in  the 

last    century    were    greater    than    those    of    the 

present  day,  it  is  not  possible  to  make  precise 

comparisons.     The  record  of  deaths  in  the  city 

167 


Masterpieces   of   Science 

of  New  York  begins  with  1804,  and  was  neces- 
sarily very  imperfect  until  the  law  of  1851. 
which  required  the  registration  of  all  deaths; 
but  it  shows  a  death-rate  of  30.2  per  i.ooo  in 
1805,  which  means  that  the  true  death-rate 
must  have  been  between  35  and  40.  At  present, 
for  a  series  of  five  years,  it  would  be  about 
20,  ha\-ing  been  below  19  in  1899,  so  that  the 
death-rate  has  been  diminished  by  at  least 
one-third.  How  much  of  this  is  due  to  improved 
sanitar}-  conditions  it  is  impossible  to  say. 
A  comparison  of  the  list  of  causes  of  death  in 
1805  with  the  list  of  causes  for  1900  shows 
great  differences,  but  much  of  this  is  due  to 
changes  in  name  and  to  more  accurate  diag- 
nosis. 

"Malignant  sore  throat"  and  "croup"  were 
well  knov^-n  to  anxious  parents  in  1800,  but 
"diphtheria"  caused  no  anxiety.  "Inflam- 
mation of  the  bowels"  was  common  and  fatal, 
but  "appendicitis"  had  not  been  heard  of. 
"Ner\"ous  fever,"  '•  continued  fever,"  and  "low 
fever"  were  on  the  lists,  but  not  typhoid,  which 
was  not  clearly  distinguished  as  a  special  form 
of  disease  until  1837,  when  Dr.  Gerhard,  an 
American  physician,  pointed  out  the  differ- 
ences between  it  and  typhus,  which  also  pre- 
vailed  at   the    commencement   of  the   century. 

One  hundred  years  ago  the  great  topic  of  dis- 
cussion in  oar  cities  on  the  North  Atlantic  coast 
was  the  means  of  preventing  yellow  fever,  which 
had  been  epidemic  in  New  York  and  Phila- 
168 


The   Progress   of  Medicine 

delphia  for  two  years.  Physicians  were  dis- 
puting as  to  whether  the  disease  was  contagious 
and  imported,  and,  therefore,  perhaps,  pre- 
ventable by  quarantine  and  disinfection,  or 
was  due  to  some  occult  condition  of  the  atmos- 
phere (which  was  the  view  taken  by  Noah 
Webster  in  his  "History  of  Epidemic  and  Pesti- 
lential Diseases,"  a  work  which  appeared  about 
the  middle  of  the  year  1800,  although  it  is  dated 
1789).  The  discussions  remind  one  of  the  re- 
mark that  a  certain  patented  form  of  electric 
light  was  surrounded  by  a  cloud  of  non-luminous 
verbosity.  For  example,  the  Committee  of  the 
Medical  Society  of  the  State  of  New  York  re- 
ported that  yellow  fever  may  be  produced  in 
any  countr}""  by  pestilential  effluvia ;  and  Webster 
concluded  that  typhus  and  nervous  fevers 
were  due  to  a  "conversion  of  the  perspirable 
fluids  of  the  body  into  septic  [poisonous]  mat- 
ter"— all  of  which  means  that  they  knew  noth- 
ing about  it.  Even  now  we  do  not  know  the 
cause  of  yellow  fever,  or  the  precise  mode  of 
its  spread;  but  we  are  sufficiently  certain  that 
it  is  due  to  a  specific  micro-organism  to  be 
confident  that  its  spread  can  be  checked  by  iso- 
lation and  disinfection  properly  applied — and 
Memphis  and  New  Orleans  are  witnesses  to 
the   truth   of  this. 

In  the  year  1800,  the  majority  of  persons  over 

twenty  years  old    were  more  or  less    pitted  by 

small-pox,  being  the  survivors  of  a  much  greater 

number   who    had    suffered    from    this    disease. 

169 


Masterpieces   of   Science 

Dr.  Miller  in  New  York  had  just  received  from 
England  a  thread  which  had  been  steeped  in 
the  newly  discovered  vaccine  matter,  and  was 
about  to  begin  vaccination  in  this  city.  To-day 
there  are  many  physicians  who  have  never  seer 
a  case  of  small-pox,  and  a  face  pitted  with  tht 
marks   of  this   disease   is   rarely   seen. 

During  the  centur}^  there  have  appeared  in  civN 
ilized  countries  two  strange  and  unfamiHar 
forms  of  epidemic  disease,  namely,  Asiatic  cholera 
and  the  plague,  the  first  coming  from  the  valley 
of  the  Ganges,  the  second  from  the  valley  of  the 
Euphrates,  and  each  having  a  long  histor>'. 
A  really  new  disease  was  the  outbreak  in  Paris 
in  1892  of  a  specific  contagious  disease  trans- 
mitted from  sick  parrots,  and  knowTi  as  psitta- 
cosis. This  little  epidemic  affected  forty-nine 
persons,  and  caused  sixteen  deaths.  Typhus 
fever  has  almost  disappeared,  while  some  diseases 
have  increased  in  relative  frequency,  in  part, 
at  least,  because  of  medical  progress.  The 
children  who  would  have  died  of  small-pox  in 
the  eighteenth  century  now  live  to  be  affected 
with  diphtheria  or  scarlet  fever,  and  the  increase 
in  the  number  of  deaths  reported  as  due  to 
cancer  is  partly  due  to  the  fact  that  a  greater 
proportion  of  people  live  to  the  age  most  subject 
to    this    disease. 

A  large  part  of  modem  progress  in  medicine 
is  due  to  improved  methods  of  diagnosis,  and 
to  the  use  of  instruments  of  precision  for  re- 
cording the  results  of  examinations.  The  use 
170 


The   Progress   of  Medicine 

of  the  clinical  thermometer  has  effected  a  revo- 
lution in  medical  practice.  Our  knowledge  of 
diseases  of  the  heart  and  lungs  has  been  greatly- 
expanded  during  the  century  by  auscultation 
[trained  listening  to  sounds]  and  percussion, 
and  especially  by  the  use  of  the  stethoscope. 
The  test-tube  and  the  microscope  warn  us  of 
kidney  troubles  which  formerly  would  not  have 
been  suspected,  and  the  mysterious  Rontgen 
rays  are  called  in  to  aid  the  surgeon  in  locating 
foreign  bodies  and  in  determining  the  precise 
nature  of  certain  injuries  of  the  bones.  Bac- 
teriological examination  has  become  a  neces- 
sary part  of  the  examination  in  cases  of  sus- 
pected diphtheria,  tuberculosis,  or  typhoid, 
and  a  minute  drop  of  blood  under  the  micro- 
scope may  furnish  data  which  will  enable  the 
skilled  physician  to  predict  the  result  in  certain 
cases  of  anaemia  [bloodlessness],  or  to  make  a 
positive  diagnosis  as  between  malaria  and  other 
obscure  forms  of  periodic  fever. 

The  means  at  the  command  of  the  physician 
for  the  relief  of  pain  now  include,  not  only  the 
general  ans:sthet"2S, — chloroform,  ether,  and 
nitrous  oxide, — but  also  the  hypodermic  use  of 
the  concentrated  alkaloids  of  opium,  bella- 
donna, and  other  narcotics,  and  the  local  use 
of  cocaine;  and  restful  sleep  for  the  weary 
brain  may  be  obtained  by  sulphonal,  chloral, 
etc.  Some  agonizing  forms  of  neuralgic  pain  are 
now  promptly  relieved  by  the  section  or  ex- 
cision of  a  portion  of  the  affected  nerve;  or  it 
171 


Masterpieces   of  Science 

may  be  forcibly  stretched  into  a  condition  of 
innocuous  desuetude.  Relief  to  the  sufferings 
of  thousands  of  neiu-otic  women,  and  of  their 
families  and  friends,  has  been  produced  by 
the  systematic  scientific  application  of  the 
rest  cure  of  Dr.  Weir  Mitchell. 

A  hundred  years  ago  the  medical  advertise- 
ment which  was  most  prominent  in  New  York 
and  Philadelphia  newspapers  was  one  of  a  rem- 
edy for  worms.  Many  symptoms  of  nervous 
and  digestive  troubles  in  children  were  in  those 
days  wrongly  attributed  to  worms.  Neverthe- 
less, there  is  good  reason  to  believe  that  para- 
sitic diseases  derived  from  animals  were  in  those  _ 
days  much  more  prevalent  in  this  country 
than  they  are  to-day.  Our  knowledge  of  the 
mode  of  origin  and  development  of  the  tape- 
worm, the  trichina  spiralis,  the  liver  fluke, 
and  the  itch  insect  has  been  gained  during  the 
nineteenth  century.  Much  the  same  may  be 
said  with  regard  to  the  peculiar  worm  known 
as  anchylostum,  the  cause  of  Egyptian  chlo- 
rosis, and  of  the  St.  Gothard  tunnel  disease, 
although  prescriptions  for  this  parasite  are 
found  in  the  Papyros  Ebers,  written  before 
the  time  of  Pharoah. 

The  limits  of  this  article  permit  of  but  a 
brief  reference  to  the  progress  in  preventive 
medicine  during  the  century.  The  studies  made 
in  England  of  the  results  of  the  cholera  epidemic 
of  1849,  and  the  experience  gained  in  the  Eng- 
lish army  during  the  Crimean  war,  led  to  some 
172 


The   Progress   of  Medicine 

of  the  most  important  advances  in  sanitary- 
science,  more  especially  to  the  demonstration 
of  the  importance  of  pure  water  supplies,  and 
of  proper  drainage  and  sewerage.  During  our 
Revolutionary  War,  and  the  Napoleonic  wars, 
the  losses  to  the  armies  from  disease  greatly 
exceeded  those  from  wounds;  and  hospital 
fever — in  other  words,  typhus — was  dreaded 
by  a  general  almost  more  than  the  opposing 
forces.  During  the  wars  of  the  last  twenty- 
five  years,  typhus  and  hospital  gangrene  have 
been  unknown,  but  some  extensive  outbreaks 
of  typhoid  fever  have  occurred,  showing  that 
our  knowledge  of  the  causes  and  mode  of  trans- 
mission of  this  disease  has  not  been  practically 
applied  to  the  extent  to  which  it  should  have 
been;  this  remark  applies  also  to  some  of  the 
most  fatal  diseases  in  civil  life.  In  the  United 
States  diphtheria  and  typhoid  fever  each  causes 
from  twenty  to  thirty  thousand  deaths  a  year, 
while  more  than  one  hundred  thousand  deaths 
are  annually  due  to  consumption.  Yet  for  each 
ot  these  diseases  we  know  the  specific  germ, 
the  channels  through  which  it  is  usually  con- 
veyed, and  the  means  by  which  this  convey- 
ance can  be  to  a  great  extent  prevented.  The 
ravages  of  these  diseases  are,  therefore,  largely 
due  to  the  fact  that  the  great  mass  of  the  people 
are  still  ignorant  of  these  subjects.  Antitoxin 
is  not  yet  used  for  either  prevention  or  treat- 
ment \n  diphtheria  to  anything  like  the  extent 
which  our  knowledge  of  its  powers  demands. 
173 


Masterpieces   of  Science 

Our  better  knowledge  of  the  causes  of  certain 
infectious  and  contagious  diseases,  and  of  the 
mode  of  their  spread,  has  been  of  great  impor- 
tance to  the  world  from  a  purely  commercial 
point  of  view,  since  it  has  led  to  the  doing  away 
with  many  unnecessary  obstructions  to  traffic 
and  travel  which  were  connected  with  the  old 
systems  of  quarantine,  while  the  security  which 
has  been  gained  from  the  modem  method  of 
cleansing  and  disinfection  is  decidedly  greater 
than  that  secured  by  tne  old  methods.  A  strik- 
ing illustration  of  the  effect  of  these  improve- 
ments is  seen  in  the  manner  in  which  the  news 
of  the  recent  outbreak  of  plague  in  Glasgow 
was  received  in  England  and  throughout  Europe. 
One  hundred  years  ago  the  city  would  have 
been  almost  deserted,  and  terror  would  have 
reigned  in  all  England.  To-day  it  is  well  under- 
stood that  the  disease  spreads  by  a  bacillus 
which  is  not  conveyed  through  the  air.  No  one 
fears  a  repetition  of  the  ghastly  scenes  of  the 
Black  Death  in  the  foiu-teenth  century.  In 
like  manner,  and  for  the  same  reasons,  Asiatic 
cholera  has  lost  most  of  its  terrors. 

The  benefits  to  the  public  of  modem  pro- 
gress in  medicine  have  been  greatly  enlarged 
by  the  establishment  of  many  small  hospitals, 
and  by  the  steady  increase  in  the  employment 
of  specially  trained  nurses  in  private  practice, 
even  in  rural  districts.  The  results  of  a  case 
of  typhoid  or  of  pneumonia  often  depend 
as  much  upon  the  nurse  as  upon  the  doctor; 
174 


The   Progress   of  Medicine 

and  affection  cannot  take  the  place  of  skill 
in  either.  For  the  great  mass  of  the  people, 
cases  of  severe  illness  or  injury,  or  those  re- 
quiring major  surgical  operations,  can  be  treated 
more  successfully  in  well-appointed  hospitals 
than  in  private  houses,  and  as  this  is  becoming 
generally  understood  the  old  feeling  against 
entering  a  hospital  for  treatment  is  rapidly 
disappearing.  Improvement  in  hospital  con- 
struction and  management  has  kept  pace  with 
progress  in  medical  knowledge;  and  in  future 
such  institutions  seem  destined  to  play  an 
increasingly  important  part  in  mimicipal  and 
village  life. 

All  progress  in  civilization  is  attended  with 
injury  to  some  individuals.  Trained  nurses 
have  deprived  some  tmskilled  labour  of  em- 
ployment; hospitals  have  injured  the  business 
of  some  physicians;  pure- water  supplies,  good 
sewers,  food  inspection,  vaccination, — in  short, 
all  effective  measures  in  public  hygiene, — inter- 
fere with  the  trade  side  of  medical  practice; 
but  upon  the  whole  the  public  at  large  benefits 
by  all  these  things.  In  one  sense  they  seem 
opposed  to  the  general  law  of  evolution,  in  that 
they  prolong  the  life  of  the  unfit ;  but  in  a  broader 
sense  they  work  in  accordance  with  this  law 
by  increasing  the  power  of  the  strong  to  pro- 
tect and  care  for  the  weak. 

All  told,  the  most  important  feature  in  the 
progress   of   medicine    during   the    century    has 
been   the   discovery   of  new  methods   of  scien- 
175 


Masterpieces   of  Science 

tific  investigation,  more  especially  in  the  fields 
of  bacteriolog}'  and  pathology*.  These  methods 
have  been  as  yet  only  partially  applied,  and 
great  results  are  to  be  hoped  from  their  exten- 
sion in  the  near  future.  They  will  not  lead  to 
the  discovery  of  an  elixir  of  life,  and  the  in- 
creasing feebleness  of  old  age  will  continue 
to  be  the  certain  result  of  li\T.ng  a  long  time, 
for  the  tissues  and  organs  of  each  man  have 
a  definitely  limited  term  of  duration  peculiar 
to  himself;  but  many  of  the  disorders  which 
make  life  a  burden  in  advancing  years  can  now 
be  palliated,  or  so  dealt  with  as  to  secure  com- 
parative comfort  to  the  patient,  so  that  "if 
by  reason  of  strength"  life  can  be  prolonged 
beyond  threescore  years  and  ten  it  no  longer 
necessarily  involves  labour  and  sorrow. 


178 


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